RSNA 2011: Listening in on the PACS Industry Soundtrack

Cacophony used to reign in the PACS industry until not too long ago, when the voices of a number of solid contenders in the PACS arena mixed with those of innumerable new market entrants.

PACS opportunities were multiplying, and it seemed like there was a free track available for anyone wanting to get some airtime about a new RIS/PACS, Web-based PACS, 3-D PACS, hosted PACS - you name it. In this growing market, the lower end of which was fragmenting, it seemed every vendor was able to get a place on stage and capture their piece of the pie.

At the2011 RSNA Scientific Assembly and Annual Meeting in Chicago last month, the PACS industry seemed to have quit the era of out-of-tune marketing communications cold turkey. The collective marketing message perhaps lacked the energy of years past, but the different voices were certainly more in harmony around PACS 2.0. Dominated by a more consolidated group of top-tier vendors, the PACS industry’s soundtrack was structured mainly along three tracks: enterprise, mobility and the cloud-based image exchange.

Meaningful Use would only come in fourth, as it was more for the vendors with an integrated RIS/PACS offering targeted at the ambulatory segments of the market.

Two of the top three largest PACS vendors for example, GE and Philips, were both vocal about enterprise PACS and mobility, even though their respective approaches were completely opposite to one another.

With regard to its enterprise strategy, GE can now pride itself in having “had a vendor neural archive (VNA) all along,” according to a representative from the company. Although like other PACS vendors, the company tries to avoid the terminology of VNA, GE is currently more active in selling its PACS-neutral archive within and outside the Centricity customer base. Philips on the other hand is launching the IntelliSpace clinical informatics portfolio -which includes the next-generation of iSite PACS, however the company is concurrently tightening the knot with middleware vendor Acuo Technologies in order to cater to customers looking for a third party VNA.

Conversely, on the mobility front, Philips can vaunt the new mobility platform that it developed in-house, which the vendor will be able to evolve based on direct customer feedback. GE on the other hand is now one of multiple vendors that are licensing the FDA-approved mobility enablement platform of Calgary Scientific rebranded as Centricity Radiology Mobile Access.

One could tell the comfortable position that McKesson, the other top-three vendor along with GE and Philips, was in at the 2011 RSNA meeting. The fastest moving PACS vendor, McKesson, is backed by a thriving healthcare IT business that is making inroads with enterprise data integration. As such, McKesson’s medical imaging group could safely focus its messaging around best-of-breed PACS storage and applications, and showcase the new nuts and bolts of Horizon PACS.

The other vendors in this consolidated top tier would be Fuji, Merge, Carestream and Agfa. While it is virtually impossible going forward for a new vendor to break into this top seven, some of these PACS vendors might at some point weigh in on some soft exit strategies. In fact, on the trailing end of this group of vendors is Siemens, which recently launched syngo.plaza PACS along with its complementary syngo.via enterprise visualization platform. While Siemens is certainly making a notable IT comeback with syngo.via, by putting forth this front-end solution much more aggressively than the underlying PACS platform, Siemens made it explicit at the 2011 RSNA meeting that, in their book, PACS has definitely become a commodity.

Among the smaller vendors, the ones determined to continue supporting their customer base and who have learned to do so while running profitable service operations might stand a chance to continue to prosper financially in the PACS market.

Going back to our musical allegory, the band and the surrounding choir of the leading seven companies were performing for the hearing pleasure of the replacement PACS public of Chicago. All were relatively on-beat.

But there was a rising note on the floor that was just audible, this one coming from relative newcomers to the industry. Never before has the industry witnessed lyrics as outspoken as these, which could have been sung by one of these new market entrants:

“Legacy PACS customer, if you’re out shopping for a PACS replacement, I’d like you to consider a better way of doing things this time around. Why don’t you take a look at our new Web-based universal enterprise viewer, and we can hook you up on cloud-based services for all of your management and archiving of images from the past 18 months on-site. Forget the old PACS model. There’s a better alternative!”

Frost & Sullivan Principal Analyst Nadim Daher has more than eight years of medical imaging expertise. His industry analysis covers the U.S. and Canadian markets and includes a focus on medical imaging informatics and medical imaging modalities.