Love All, Serve All
The Pacific's First Integrated Cath Lab Goes Live in Fiji
How Techunison connected the Philips Azurion 7 B20/15 Bi-Plane with Orthanc PACS, DICOM, and Frappe Health — delivering a fully paperless, open-source cardiac imaging ecosystem to the Sri Sathya Sai Sanjeevani Children's Heart Hospital, Suva, Fiji.
Frappe Health
Orthanc PACS
DICOM Integration
Azurion 7 B20/15
Open Source






408+
Free Heart Surgeries
67,510+
Patients Treated Free
26,922
Children Heart Screened
FJD5M
Largest NGO Project in Fiji
100%
Open-Source Stack
2-Plane
Bi-Plane DICOM Archived
1-Click
Image Access from Records
1st
Integrated Cath Lab Pacific
About the Client
A Hospital Built on Compassion
Serving the Least, the Last & the Lost
The Sri Sathya Sai Sanjeevani Children's Heart Hospital at Nasese, Suva is the only paediatric cardiac hospital in the entire South Pacific region — and every single procedure performed within its walls is provided completely free of charge. No surgery fee. No medication charge. No bill of any kind.
Founded under the Sai Prema Foundation Fiji, a registered NGO and Charitable Trust, the hospital was inaugurated on 27 April 2022 by Fiji's then Prime Minister and Sadguru Sri Madhusudan Sai. The FJD 5 million facility is the largest charitable project ever undertaken by any NGO in Fiji's history.
Before this hospital, a child born with congenital heart disease in Fiji faced surgery costing upwards of FJD 100,000 overseas — impossible for most families.
408+
Free Paediatric Heart Surgeries
4M+
Free Meals — Sai Annapoorna Program
4,700+
Pints of Blood Donated
14
International Surgical Teams
"There is no bill on the counter. Everything is totally free of charge — every surgery, every procedure, all medications."
— Mr. Sumeet Tappoo, Director, Sai Prema Foundation Fiji
Foundation Mission
Medicare · Educare · Sociocare
Three Pillars. One Purpose. Serving All of Humanity.
🏥
Medicare
Free heart surgeries, rural medical camps across Fiji's 330 islands, specialist training, dental care, and paediatric cardiac screening — all without charge.
📚
Educare
Free overseas training for Fijian doctors in paediatric cardiology, building sustainable local surgical capacity so Fiji can one day run the hospital itself.
🤝
Sociocare
The Sai Annapoorna program has distributed over 4 million free meals. Blood drives have collected 4,700+ pints, bolstering Fiji's national health system.
Leadership
The People Behind the Mission
Nationally and internationally recognised — Fiji's highest state honour, the Companion of the Order of Fiji, was awarded to the founders of this mission of compassionate cardiac care.

Sadguru Sri Madhusudan Sai
Spiritual Founder & Global Humanitarian
The spiritual force behind the One World One Family global mission, Sadguru Sri Madhusudan Sai leads a movement of love and service spanning 80+ countries across healthcare, education and nutrition. His vision transformed Fiji's approach to paediatric cardiac care — making world-class heart surgery freely accessible to every child, regardless of circumstance. Awarded Fiji's highest state honour, the Companion of the Order of Fiji.

Mr. Mahendra Tappoo
Chairman & Founding Trustee
The visionary architect of Fiji's largest-ever NGO project, Mr. Mahendra Tappoo co-founded the Sai Prema Foundation in 2016 with an unwavering commitment to serve the least, the last and the lost. Under his leadership, a FJD 5 million hospital was conceived and built — the first and only dedicated paediatric cardiac hospital in the entire South Pacific. Recipient of the Companion of the Order of Fiji.

Mr. Sumeet Tappoo
Foundation Director
A Bollywood singer turned global philanthropist, Mr. Sumeet Tappoo drives the day-to-day mission of the Sai Prema Foundation with infectious energy and purpose. He champions free paediatric cardiac care across Fiji's 330 islands, personally overseeing outreach, fundraising and community engagement. His rallying words — "There is no bill on the counter. Everything is totally free of charge" — have become the foundation's defining statement of compassion.

Dr. Krupali Tappoo
Hospital Director
An award-winning social entrepreneur and clinician, Dr. Krupali Tappoo leads all medical programmes, international surgical partnerships and clinical quality at the hospital. She has built a remarkable network of volunteer surgeons from 14 countries, ensuring that children across Fiji and the Pacific receive the highest standard of paediatric cardiac care — all delivered entirely free of charge. Recipient of the Companion of the Order of Fiji.

Dr. Shaun Setty, MD
Co-President & Medical Director, GHN
A triple-board-certified congenital cardiac surgeon at Stanford University, Palo Alto, Dr. Shaun Setty brings world-class surgical expertise and global humanitarian purpose together in equal measure. Certified in surgery, thoracic surgery, and congenital heart surgery, he serves as Director of Global Cardiac Care at Stanford and Co-President of the Global Health Network. His partnership with the Sai Prema Foundation has connected Fiji to an international network of specialist cardiac surgeons, directly enabling the free life-saving procedures the hospital provides to children across the Pacific.

Ramesh Dharmaraj
Technology Solutions Director
The architect of the open-source digital backbone powering this cath lab deployment, Ramesh Dharmaraj brings deep expertise in cloud solutions, healthcare ERP, and AI-driven systems to one of the most ambitious humanitarian technology projects in the Pacific. He designed and implemented the three-layer integration connecting the Philips Azurion 7 B20/15 bi-plane, Orthanc PACS, and Frappe Health — delivering a fully paperless, enterprise-grade imaging ecosystem at zero proprietary licensing cost. His work ensures that world-class cardiac imaging infrastructure is now permanently and sustainably embedded within the hospital's open-source digital ecosystem.
The Hardware — Philips Azurion 7 B20/15
World-Class Interventional Imaging System
A high-performance bi-plane system engineered for advanced cardiovascular, neurovascular, and peripheral procedures — delivering exceptional clarity and flexible system design for minimally invasive treatments.
🖼️
Imaging & Technology
-
High-definition flat detector imaging for exceptional clarity
-
Real-time advanced image processing engine
-
Adaptive radiation dose optimization for patient safety
-
Superior soft tissue and device visualization
-
Wide-field imaging coverage for complex interventions
-
Simultaneous bi-plane acquisition from two orthogonal planes
-
Native DICOM XA output — DICOM C-STORE push to PACS
🏗️
System Design
-
Ceiling-mounted C-arm with precise motorized movement
-
Flexible table positioning for diverse procedure types
-
Ergonomic and space-efficient layout for busy cath labs
-
Designed for cath labs and hybrid OR installations
-
Dual-plane gantry with independent angle control
-
Lead glass integration for radiation shielding
⚡
Workflow & Controls
-
Integrated touchscreen and smart control module
-
Automated workflow presets for faster procedures
-
Customizable imaging parameters per procedure type
-
Seamless data integration and reporting tools
-
Dual Philips displays at operator workstation
-
Operator console with real-time angiographic feedback
📡
Connectivity & Integration
-
DICOM C-STORE / C-FIND / C-MOVE protocol support
-
Automatic study tagging with patient demographics
-
PACS-ready — integrates with Orthanc and all major servers
-
Modality worklist support for HMIS synchronization
-
REST API compatibility for health ecosystem linking
-
On-premise or hybrid cloud-ready architecture
Clinical Applications
❤️
Cardiology Interventions
🧠
Neurovascular Imaging & Treatment
🩸
Peripheral Vascular Procedures
🔬
Image-Guided Surgical Therapy
Live Installation · Suva, Fiji · 2026
From the Ground Up
Real photos from the Azurion 7 B20/15 bi-plane installation at Sri Sathya Sai Sanjeevani Children's Heart Hospital.





The Challenge
World-class hardware. The digital backbone still to build.
A Cath Lab Without a Connected System is Just a Machine
With the Azurion 7 B20/15 installed, the hospital had the hardware to save lives. But without PACS, DICOM integration, or a unified HMIS, every image risked remaining isolated on the modality.
🏝️
Geographic Isolation
330-island nation. Patients previously needed to travel to Australia or NZ for cardiac procedures costing over FJD 100,000.
🗄️
No PACS Infrastructure
Without a PACS server, bi-plane DICOM images from the Azurion had no sustainable long-term archive, retrieval, or sharing capability.
🔗
Siloed Clinical Records
Without a unified HMIS, imaging data and clinical encounters would remain disconnected — creating dangerous gaps in patient care continuity.
💰
Zero Budget for Licensing
A fully charitable hospital providing all services free of charge cannot sustain commercial PACS or proprietary HIS licensing fees.
Techunison's Solution
Open-source, open hearts
A Three-Layer Architecture Built on Open Standards
1
DICOM from the Azurion
The Azurion 7 B20/15 is configured to push all acquired images from both planes to the Orthanc server over the hospital's internal network using the DICOM C-STORE protocol — each study tagged with patient identifiers, modality type (XA), and referring physician.
2
Orthanc as the PACS Backbone
Orthanc was chosen for its lightweight footprint, powerful REST API, and open-source licence. Running on a local server within the hospital's network, it provides browser-based DICOM viewing with zero client software installation required — and automated backup policies protecting every image.
3
Frappe Health as the Clinical Hub
Frappe Health ties everything together. PACS study UIDs from Orthanc are automatically associated with each patient master record in Frappe — meaning a physician reviewing a patient file can pull up their cath lab studies with a single click.
End-to-End Data Flow — From Procedure Room to Patient Record
1
Patient Procedure
2
Azurion Bi-Plane Capture
3
DICOM C-STORE Push
4
Orthanc PACS Archive
5
Frappe Health Record
6
Clinician 1-Click Access
Technical Specification
The Full Stack
Component | Technology | Role | Licence |
|---|---|---|---|
Imaging System | Philips Azurion 7 B20/15 Bi-Plane | Ceiling-mounted dual C-arm; native DICOM XA output from both planes simultaneously | Commercial Hardware |
Imaging Protocol | DICOM C-STORE / C-FIND / C-MOVE | Industry-standard medical imaging transport layer between modality and PACS server | Open Standard |
PACS Server | Orthanc (v1.12+) | Lightweight open-source DICOM server; REST API; built-in DICOM web viewer; on-premise local hosting | Open Source (GPLv3) |
HMIS Platform | Frappe Health on ERPNext | Patient records, OPD/IPD, billing, clinical notes, PACS study UID direct linking in patient file | Open Source (GPLv3) |
Framework | Frappe Framework | Full-stack web framework; role-based access control; workflow engine; low-code customisation | Open Source (MIT) |
Infrastructure | On-Premise Linux Server | Local network hosting of Orthanc + Frappe Health; automated backup; zero cloud dependency | Open Source |
Delivery
Implementation Roadmap
Phase 1
Discovery — Site Assessment & Architecture Design
Network topology review, server sizing, DICOM worklist configuration planning, and Frappe Health module scoping aligned to the Fiji hospital context and zero-budget licensing constraint.
Phase 2
Infrastructure — Physical Installation & Network Setup
Azurion 7 B20/15 bi-plane gantry ceiling installation, control room console configuration, lead glass fitting, and hospital network setup for DICOM traffic routing.
Phase 3
PACS Deployment — Orthanc Configuration & DICOM Connectivity
Orthanc server installation, DICOM AE title setup, Azurion DICOM push routing, automatic study tagging with patient demographics, and browser-based DICOM web viewer configuration.
Phase 4
HMIS Go-Live — Frappe Health Clinical Integration
OPD, IPD, and cath lab procedure workflows configured in Frappe Health. PACS study UID linking implemented in patient records. Staff training on Frappe Health and Orthanc administration.
Phase 5 — Future Roadmap
AI Reporting & Telemedicine Integration
Structured cath lab reporting within Frappe Health, AI-assisted image annotation, and remote specialist telemedicine consultation for outer island referrals.
Delivered In Partnership With

Cardiology Interventions
Cardiology Interventions

Cardiology Interventions
Cardiology Interventions

Cardiology Interventions
Cardiology Interventions

Cardiology Interventions
Cardiology Interventions

Cardiology Interventions
Cardiology Interventions
Outcomes
Transforming lives, one heartbeat at a time
Measurable Impact
100%
Open-source software stack — zero proprietary licensing overhead for a fully charitable hospital
2-Plane
Both bi-plane imaging feeds automatically archived in PACS with full patient demographics tagging
1-Click
Clinicians access complete imaging study history directly from the Frappe Health patient record
"Open-source technology, implemented with rigour and clinical understanding, can deliver enterprise-grade healthcare infrastructure to any corner of the world — and this deployment in Fiji is living proof that compassion and code can coexist."