I recently enjoyed a conversation with Gino Johnson, Sr. VP and General Manager of CapSite regarding a recently released study CapSite conducted on the U.S. market for PACS replacement (2011 U.S. PACS Replacement Study). The study addressed both radiology and cardiology replacement, with an interesting difference that I will comment on later.
The Importance of Definitions
Having been peripherally involved in several earlier initiatives at assessing the PACS market, I know how important definitions can be when surveying the market. One of the earliest companies involved in these efforts was Technology Marketing Group, which conducted some of the earliest PACS studies. One tell-tale sign of a problem with definitions was the list of companies provided when subjects were asked whose PACS they had. Responses included Computed Radiography (CR) vendors, laser printer vendors, teleradiology vendors, and who knows what else. Consequently, it was always difficult to differentiate who truly had a PACS. Efforts to further differentiate amongst PACS and PACS components were considered at that time to be too complicated.
In the case of cardiology, definitions are further complicated by the larger scope of cardiology services. In terms of how I differentiate them, a Cardiology PACS is engaged in managing images and in some instances with structured reporting capabilities associated with the images. On the other hand, a Cardiovascular Information System (CVIS) may encompass those same tasks, plus the addition of study, patient, and administrative management tools. It is analogous to radiology to refer to PACS and RIS to refer to CPACS and CVIS. And what of Hemodynamic systems? Are they included as well? This is how I view the world, but certainly a vendor or cardiology service may have their own perspective to such definitions.
At this year’s HIMSS meeting, a vendor relayed to me that they conducted a focus group on the “Vendor Neutral Archive” (VNA), and came away with the impression that one of the biggest factors in assessing the technology was that no one could agree on what the term meant!
The bottom line? I am all for market studies on the implementation of technology, and the opportunity for replacement, but I am concerned that the industry needs to pay particular attention to the definitions to assure a common understanding of the results. That is why I am pleased to see that CapSite gets this! According to Gino, they thoroughly research the market before the study to identify the correct set of vendors, as well as provide the ability to enter others if necessary. They also define any system definitions so that respondents have a clear idea of what they are responding to.
Instead of the requirement for clarification falling on the researchers though, perhaps there is an opportunity to address definitions standardization with the vendors. If there is consensus, there is the opportunity to improve the quality of responses and perhaps make utilization of the results more meaningful.
As for the recent CapSite study:
Of particular interest for radiology is that 52 percent of those surveyed have PACS that are more than five years old. Radiology PACS are fairly well saturated, having peaked in terms of implementation between 2005 and 2007. Twenty-one percent of those surveyed indicate they are considering a PACS replacement, with over fifty percent of those planning to replace in within the next twenty-four months. There are certainly encouraging statistics for those in the radiology PACS business!
Results for cardiology were significantly different. Most important is the fact that most Cardiology PACS are newer, as evidenced by the fact that forty-six percent of respondents have had a Cardiology PACS installed for two years or less! Only fifteen percent of respondents are considering a Cardiology PACS replacement, the majority within the next twenty-four months. Clearly, these replacements may come from predominantly the older Cardiology PACS installations.
So it is clear the replacement market favors radiology, as cardiology is newer. From my experience though, cardiology has the bigger challenge to achieve parity with radiology in terms of an integrated CPACS-CVIS solution.