The Medtech Factory of the Future

Any one of us could find our­selves in this sit­u­a­tion at the emer­gency room (ER) of a major hos­pi­tal: an ambu­lance arrives and the para­medics bring a patient through the doors on a yel­low-wheeled stretch­er. A woman in her mid-40s, she had abrupt­ly lost sen­sa­tion in her right arm and leg. A doc­tor quick­ly appears and speaks with the patient under the bright lights of the ER. Her ini­tial diag­no­sis: “Reduced blood sup­ply to the brain.” Treat­ment needs to begin right away.

An anes­the­si­ol­o­gist admin­is­ters a seda­tive and the patient loses con­scious­ness. The doc­tor inserts a wire-like catheter into a blood ves­sel in the groin and maneu­vers it up into the affect­ed part of the brain. A large screen shows her the instrument’s posi­tion and the pat­tern of the blood ves­sels. She dis­cov­ers that a throm­bus, or blood clot, is block­ing an artery in the brain. Using the catheter, she suc­ceeds in suc­tion­ing it away and there­by free­ing the ves­sel. An hour later the patient can feel her right side again. A very for­tu­nate outcome—for she could soon have suf­fered a stroke with seri­ous con­se­quences. Thanks to the pre­cise diag­no­sis and prompt appro­pri­ate treat­ment, she will leave the hos­pi­tal in a few days in good health.

Scenes like this now tran­spire thou­sands of times a year at hos­pi­tals in Ger­many that have the right equip­ment. The coun­try is not alone in this respect. “Sim­i­lar mea­sures are taken in Japan and Nepal, in South Africa and the Unit­ed States—new image-sup­port­ed process­es have dra­mat­i­cal­ly improved the prospects for stroke patients,” says Horst Schmidt, Head of Power & Vac­u­um at Siemens Health­i­neers, a lead­ing com­pa­ny in med­ical technology.

“Time is brain” is a for­mu­la also heard at neu­ro­log­i­cal depart­ments in hos­pi­tals. Endovas­cu­lar stroke treat­ments require not only skill on the part of med­ical prac­ti­tion­ers, but also the abil­i­ty to see exact­ly where their instru­ments are in patients’ bod­ies. This can be achieved by tak­ing mul­ti­ple images in quick suc­ces­sion and com­pil­ing them into a type of video. Siemens Health­i­neers pro­duces this imag­ing equip­ment. “Our devices are essen­tial­ly nav­i­ga­tion sys­tems for doc­tors,” says Schmidt. And he and his team are respon­si­ble for man­u­fac­tur­ing the core com­po­nent of these systems.

Schmidt’s office is in Siemens Health­i­neers’ newly erect­ed High-Ener­gy Pho­ton­ics (HEP) Cen­ter of Siemens Health­i­neers in Forch­heim, a south­ern Ger­man town near Nurem­berg with a pop­u­la­tion of 34,000. Locat­ed right next to the Main-Danube Canal, this new pro­duc­tion site replaces two older plants that had reached their capac­i­ty lim­its. The HEP Cen­ter will now be man­u­fac­tur­ing the core parts for many of the Siemens Health­i­neers imag­ing sys­tems. Com­pa­nies that expect high per­for­mance from their employ­ees need to offer good work­ing atmos­pheres: attrac­tive con­di­tions, a pos­i­tive team spir­it, high moti­va­tion. This new build­ing hous­es pro­duc­tion and admin­is­tra­tive facil­i­ties in close prox­im­i­ty. Each floor has a casu­al cof­fee bar, where fac­to­ry and office staff can min­gle. Every­day con­tact also fos­ters short paths and prompt solu­tions in inter­dis­ci­pli­nary col­lab­o­ra­tion. How­ev­er, that’s just one small—albeit important—reason why the HEP Cen­ter is a light­house project not only for the med­ical tech­nol­o­gy indus­try, but also for future pro­duc­tion envi­ron­ments in general.

New pro­duc­tion facil­i­ties nat­u­ral­ly need to focus on effi­cien­cy, automa­tion, and dig­i­tal­iza­tion these days. The entire HEP Cen­ter is dig­i­tal­ized and con­nect­ed, and every part of it is dig­i­tal­ly mapped. Yet no jobs have been cut. “The Cen­ter was built to pro­mote growth by rais­ing out­put,” explains Schmidt. He men­tions two more key aims: qual­i­ty and pre­ci­sion. The X‑ray tube assem­blies made at the HEP Cen­ter are installed in X‑ray, mam­mog­ra­phy, CT, and inter­ven­tion­al radi­og­ra­phy sys­tems of Siemens Health­i­neers enabling catheter and other appli­ca­tions for neu­ro­log­i­cal and car­dio­vas­cu­lar care. “It’s a high-end field,” he notes. “Our cus­tomers are doc­tors from around the world who want the best pos­si­ble care for their patients, and are also increas­ing­ly inter­est­ed in mobile units. They’re con­stant­ly seek­ing even bet­ter qual­i­ty and high­er res­o­lu­tions to be even quick­er and more accu­rate in their diag­noses and actions.”

A key part of this tra­jec­to­ry con­sists of automat­ing and dig­i­tal­iz­ing pro­duc­tion. In 2019, Siemens Health­i­neers worked with a team from the Porsche Con­sult­ing man­age­ment con­sul­tan­cy to devel­op its vision of a smart fac­to­ry. “Back at the begin­ning we were look­ing down quite a long road,” says Dr. Jens Fürst, Prin­ci­pal Key Expert Dig­i­tal­iza­tion & Automa­tion. “But we’ve cov­ered it amaz­ing­ly fast.” The new com­plex, with an invest­ment of around 350 mil­lion euros, was com­plet­ed in less than five years—a remark­able peri­od of time for a project of that com­plex­i­ty con­sist­ing of three broad pro­duc­tion floors and six nar­row­er adja­cent office floors for a total sur­face area equiv­a­lent to eight soc­cer fields.

Dr. Fürst likes to take guests onto the inte­ri­or ‘bal­cony’, a nar­row gallery on the third floor of the pro­duc­tion hall with an impres­sive panoram­ic view of the assem­bly lines. The birds-eye per­spec­tive affords a good overview of the pro­duc­tion steps for the X‑ray tubes as well as the gen­er­a­tors. Put very sim­ply, the X‑ray tubes are first made in a clin­i­cal clean room. At night they under­go high-volt­age ‘con­di­tion­ing’ to achieve even high­er lev­els of clean­li­ness by auto­mat­ed robots. When employ­ees arrive for the early shift the next day, they test the tubes’ func­tion­al­i­ty and pre­ci­sion man­u­al­ly in insu­lat­ed cab­ins. Only then are the tubes released for instal­la­tion in their end devices at other plants.

Dr. Fürst works close­ly togeth­er with Dr. Markus Kaup­per. “Five years ago, I was excit­ed about the tech­ni­cal and dig­i­tal­iza­tion prospects, but couldn’t real­ly judge what would be pos­si­ble from today’s per­spec­tive,” says the lat­ter in recall­ing the ini­tial stages of the new plant. Today, Dr. Kaup­per is the HEP Center’s Head of Digitalization.

Near­ly every part of the fac­to­ry along with every process and every com­po­nent that goes through it is dig­i­tal­ly mapped. The dimen­sions, phys­i­cal prop­er­ties, and per­for­mance data are all known, form­ing a dig­i­tal twin of the fac­to­ry. “The HEP Cen­ter is our first com­plete­ly dig­i­tal­ized fac­to­ry and a cru­cial part of our smart fac­to­ry net­work,” says Dr. Peter Schardt, Chief Tech­nol­o­gy Offi­cer at Siemens Health­i­neers. “A reli­able and con­nect­ed pro­duc­tion envi­ron­ment is of cru­cial impor­tance in the med­ical sec­tor,” he adds.

If a prod­uct doesn’t pass its final qual­i­ty con­trol with fly­ing col­ors, the experts start by search­ing for pos­si­ble caus­es in the dig­i­tal twin. They might ascer­tain, for exam­ple, that the grip­per sur­faces at a cer­tain spot are not an ideal match for the prod­uct, which can lead to inac­cu­ra­cies. They also test new pro­duc­tion lines vir­tu­al­ly to elim­i­nate any prob­lems before they go into oper­a­tion. “They’ll usu­al­ly then run quite smooth­ly when we put them into actu­al prac­tice,” says Dr. Kaup­per. This rep­re­sents an enor­mous boost in effi­cien­cy, espe­cial­ly for small pro­duc­tion lines like most of those at the Center.

Because the dig­i­tal twin is con­stant­ly fed with real data that are sup­port­ed by arti­fi­cial intel­li­gence, Siemens Health­i­neers is also in a posi­tion to make increas­ing­ly pre­cise pre­dic­tions. Com­po­nent wear is one exam­ple. As part of the Siemens Health­i­neers Tube­Guard pro­gram, some physi­cians allow the com­pa­ny access to their sys­tems’ sen­sors while in oper­a­tion. The data can be used to pre­dict when the X‑ray tube will fail with a high level of accu­ra­cy. “A ser­vice tech­ni­cian is already there with a replace­ment before the cus­tomer noti­fies us,” says Schmidt. This rep­re­sents yet anoth­er boost in effi­cien­cy, not only for Siemens Health­i­neers but also for the hos­pi­tals and health­care per­son­nel who can then plan exact­ly for the com­par­a­tive­ly brief down­times need­ed for service.

Work at the HEP Cen­ter has also brought fun­da­men­tal changes for the staff. “You can’t impose these lev­els of automa­tion and dig­i­tal­iza­tion overnight,” says Ver­e­na Gol­lisch, Trans­for­ma­tion Man­ag­er at the Cen­ter. “A lot of the pre­vi­ous tasks are no longer need­ed, and many peo­ple had to adopt a new approach to their work. Some view it as an oppor­tu­ni­ty, oth­ers can be daunt­ed by it. We’ve always found it impor­tant to get our per­son­nel on board early on, have them help shape the changes, get their feed­back, and make the Center’s new oppor­tu­ni­ties evi­dent to everyone.”

Count­less events encour­aged employ­ees to help get the HEP Cen­ter up and run­ning. These includ­ed hackathons where the employ­ees could write pro­grams to improve process­es, and pro­tect­ed spaces where they could try out new activ­i­ties. The fac­to­ry is now near­ly com­plete­ly up and run­ning, and Dr. Kaup­per empha­sizes that the employ­ees have han­dled the adjust­ment well. “We’ve dis­cov­ered many new tal­ents among our team mem­bers,” he remarks. “There’s a logis­tics spe­cial­ist, for exam­ple, who enjoys pro­gram­ming in her spare time and devel­oped an app that lets cell phones func­tion as scanners.”

Many work­places now have large screens that show employ­ees what they should be doing with which tools in the next steps of their work. While this could be viewed as micro­manag­ing, it can also be wel­comed as assis­tance or as a direct form of qual­i­ty con­trol that the com­put­er assumes for the work­er. “For­tu­nate­ly, our employ­ees have adopt­ed the view that the com­put­ers aren’t elim­i­nat­ing, but rather expe­dit­ing, their work,” says Gol­lisch. And that is in fact the case at the vast major­i­ty of work sta­tions. The peo­ple and their machines and pro­grams com­ple­ment each other, because each can con­tribute their respec­tive strengths. But the peo­ple remain in charge. And are irre­place­able in many areas any­way. Siemens Health­i­neers employs glass blow­ers, for exam­ple, to pro­duce its X‑ray tubes. This clas­sic skilled trade is indis­pens­able for the high-end prod­ucts made at the HEP Center.

That might be yet anoth­er les­son to be learned from this light­house project: one should focus on automa­tion and digitalization—yet rely on one’s employ­ees at the same time. Only when every­one and every­thing work togeth­er can it real­ly be con­sid­ered to be a fac­to­ry of the future.