When it comes to picture archiving and communication systems (PACS), most clinicians in an acute-care setting prefer a system designed by radiologists for radiologists. That's one of the key findings of a report from the Orem, Utah-based KLAS ( www.KLASresearch.com).
The report, “A Read on PACS: Hospital Expectations Rising,” examines a market that is highly mature along a number of dimensions, from the level of saturation to the level of expectations among end-users. KLAS researchers and CIOs alike agree that, given the expectations of hospital healthcare IT leaders and end-users, the competition for market share will only continue to intensify.
It is in that context that the PACS vendor that was most highly ranked by CIOs and others surveyed by KLAS was founded by a radiologist and has become known for valuing the feedback of its customers. According to the report, which was published in November 2010, DR Systems Unity took home the honors for acute-care with an overall performance score of 86.0 out of 100. (Coming in at number two was McKesson Horizon Medical Imaging, with an overall score of 83.2.)
For DR Systems, capturing the number one spot in the acute-care arena indicates that the company has adapted to its rapid growth and has renewed its focus on customer service and support, according to Ben Brown, who is KLAS general manager for medical imaging and medical equipment. The fact that DR Systems was founded by a radiologist also gives the company an edge, Brown believes. “It's really been a radiology-focused company,” he says.
DR Systems solicits input from its customers, as well. User groups are regularly asked to submit lists of upgraded features they would like to see incorporated, and the company prioritizes the items on the wish lists, says Brown, who adds that the vendor has found a niche among hospitals of between 200 and 500 beds.
Among the larger, multi-site hospital organizations, vendors like McKesson, Philips, GE, and FUJIFILM still dominate mindshare for PACS deals. But Brown is quick to point out that this market segment is already 95 percent to 98 percent saturated and is well past the initial go-live stage. As a result, these organizations are now concentrating on upgrading existing PACS or contemplating a future system replacement.
However, given the up-front costs, the economy, and the potential effects of meaningful use on radiology, Brown says he has seen a limited number of these hospitals pull the trigger on placing an order. Replacement activity is increasing, especially at the high end of the PACS market. He also observes that there is a discernible difference between large hospitals and smaller community hospitals when making that leap. “In the large hospital market, technology is the driver. Price is probably a close number two. In the community hospital market, price is number one,” he says.
Product availability also is a factor in market share. “There are only a handful of vendors that compete at the highest end of the market,” Brown says. “There are quite a few vendors that are very successful in the smaller market, but provider confidence in their ability to scale up limits the number of vendors that typically compete in the high end of the PACS market,” he says.
One persistent problem, especially for large hospitals that have tended to purchase best-of-breed systems, is achieving interoperability across disparate platforms. In Brown's view, interoperability issues have even been a challenge for vendors that offer integrated systems, which often come up short in the PACS arena, he says. “Epic doesn't have a PACS, but it has an integrated EMR/RIS. GE Healthcare has a RIS, PACS, and EMR, but they have acquired them from other companies. Philips has a large customer base with its PACS, but it doesn't have an EMR.”
Brown notes that “one of the reasons Epic and Cerner are successful is that they have an integrated platform.” However, he adds that “Cerner has a great integrated system, but a majority of Cerner hospitals have not gone with Cerner PACS.” Rick Schooler, senior vice president and CIO of Orlando Health in Florida, says the problem of interoperability is compounded when different hospital departments and off-site radiology groups use different PACS. “Each specialist has its own preference for a PAC system,” he says. “What they want is the functionality. But you can't find it in one solution.”