Was the glass half-empty or half-full? That perceptual question could have been answered in any of a number of ways by those attending the annual meeting of the Radiological Society of North America (RSNA), being held Nov. 30-Dec. 5 at Chicago’s

McCormick Place

convention center in downtown Chicago.

One the one hand, RSNA 2008 counted slightly fewer attendees and vendor-exhibitors. This year, as of Sunday evening, the annual conference of radiological professionals and healthcare executives counted 55,440 attendees, compared to 58,021 last year on the same conference day-one. What’s more, 733 exhibitors paid for 516,000 square feet of exhibit space this year, compared with 757 exhibitors taking up 535,300 square feet in 2007. Foot traffic, as observers noted, was also visually lighter.

Still, RSNA remains one of the largest healthcare conferences in the world; and while attendance and exhibitorship are down slightly this year, the RSNA conference remains a must-attend for healthcare professionals—and vendors—from all over the world. The conference remains nearly unique in its combination of size and internationalism; as usual this year, one can hear French, Italian, Spanish, Portuguese, German, Swedish, Russian, Chinese, Japanese, Korean, Arabic and Hindi, among many other languages being spoken, by healthcare professionals from dozens of countries across the globe.

What is clear is that the global economic downturn (officially declared a recession in the U.S. earlier today, by the National Bureau of Economic Research) is impacting the purchasing of diagnostic imaging-related information systems, including PACS and RIS (radiology information systems). The question—one that no one can yet fully answer—is the degree to which imaging-related IT purchasing will be affected.

Vendor executives are putting the best face on things, and clearly hoping for the best. At its annual RSNA media breakfast this morning, Bernd Montag, Ph.D., CEO of the Imaging and IT Division of Siemens Healthcare (which has offices in Germany and in Malvern, Pa.), declined to predict sales figures for his company for 2008-2009, but emphasized that Siemens’ focus on long-term research and development investment, and pursuit of global market share across all the clinical modalities, PACS, RIS, and EMR, should keep it well-positioned compared to its competitors in the near future.

Montag also told Healthcare Informatics later that “Certainly, the challenges for our customers are bigger than usual. Those who have a clear strategy will be successful. And the competition among our customers will be a little bit more fierce,” Montag said. “But,” he added, “we feel ourselves to be very well positioned, because we have the right solutions for this situation. Answering the question of improving quality while reducing costs is at the core of the issues facing us. And especially in rough times, people come to us. And we’ve been doing a lot of development in previous times that were not so rough. We will see a challenge in volume, but hope to increase market share.”

Among the more worrisome questions around both IT and modality purchasing and replacement for vendors these days is the credit crisis in the U.S. and abroad. But things aren’t as dire as mainstream media headlines might indicate, Randy Waring told Healthcare Informatics. Waring, the managing director of the Hospital Enterprise Group at the Chicago-based GE Healthcare Financial Services, the largest financing arm attached to any of the vendors in the imaging and imaging IT space, noted that, “Though things tightened up dramatically after September 15, the credit markets are starting to open up now.” What has changed, Waring told Healthcare Informatics, is that hospitals that until very recently would simply have paid cash for new IT investments, are now seeking financing in order to preserve some cash liquidity. And though “The majority of hospitals are waiting until mid-2009 to seek new access to capital,” Waring added that leasing (for hardware) and private-placement tax-exempt financing (for software and implementation costs and some types of hardware) are becoming financing options of choice, even as “The public bond market is not looking good.”

Waring expects credit to remain tight on the provider side of healthcare for sometime. “I think this credit crisis will carry us well into 2009,” he said, adding that “Even as things improve in later 2009 and into 2010, there will still be more limited access to capital than back in the ‘glory days’ of 2006,” when credit lines were easily accessed. Still, Waring said, pressures from purchasers and payers to make investments in information systems that can improve patient care quality and patient safety and enhance operational efficiency will inevitably not be put off for too long. Even Standard and Poor’s and Moody’s Investor Service, he noted, “are looking to see hospitals invest in EMR, CPOE, all those technologies, in order to drive improvements in quality and safety. If not, it will be a concern when their bonds are being rated.”

So RSNA has started off on a less exuberant note than in past years. But with several days to go, there’s clearly more to find out ahead at

McCormick Place

. Stay tuned to this blogspot for further reports from RSNA 2008.