At a time in the summer when many in the U.S. are suffering in sweltering heat, perhaps reading this blog will be the conceptual equivalent, for some readers, of having a nice flavored ice in the shade of an awning. After all, this is all about the Arctic.
Specifically, it’s about a tiny town of 7,000 people on Baffin Island, called Iqaluit, which is the capital of the Arctic territory of Nunavut, in the far north of Canada.
Iqaluit, the capital of Nunavut, is closer to Greenland than to Ottawa
I was fascinated to read in AuntMinnie.com about the arrival of a PACS (picture archiving and communications system) system in Iqaluit, the implementation of which really is changing lives way up there, in a region of Canada that is closer to Greenland than to Toronto. As AuntMinnie.com’s Louise Gagnon noted, in her June 17 report on the subject, Iqaluit is 1,296 miles from Ottawa, Canada’s capital (that is the same distance as from New York City to Miami!).
Yet until Qikiqtani General Hospital installed a $2.1 million CT scanner and PACS recently, its residents really were very medically isolated, and if it was decided that they needed to undergo a CT scan, they had to be flown to Ottawa for a CT scan—via cargo plane. Imagine having to get on a plane in New York and having to fly to Miami just for a CT scan.
As Gagnon’s report noted, “The harsh weather of the Canadian Arctic sometimes further slowed reporting times between Iqaluit and Ottawa by delaying the cargo planes,” quoting Jennifer Sharpe, the hospital’s manager of diagnostic imaging, as she spoke at the 2015 Joint Congress on Medical Imaging an Radiation Sciences, held in Montreal in June.
As Qikiqtani General’s Sharpe noted, long waits for access to diagnostic imaging procedures and for the results of those procedures, were finally eliminated, with the implementation of both the CT scanner and the new PACS system.
Further south here in the United States, PACS availability is now virtually universalized. Indeed, the PACS solutions market in particular has become saturated in the U.S., with many vendors struggling amid a highly competitive, mature market, with the vast, vast majority of hospitals, medical groups, and imaging centers already having fully implemented PACS systems in place, and most implementations now second- and even third-generation replacement installations.
The announcement on May 13 that the Stamford, Conn.-based Fuji Medical Systems USA had acquired the Wauwatosa, Wis.-based TeraMedica illustrates just how mature the PACS market is now. As we reported then, that acquisition was “the culmination of a partnership that began in 2013, when the two firms signed a deal in which TeraMedica had agreed to provide its VNA [vendor-neutral archive] technology to Fuji. The deal emerges as the latest in a long series of consolidating acquisitions, in the context of a PACS (picture archiving and communications systems) HIT market that has become mature and whose opportunities to engage new hospital and medical group customers has waned in the past few years.”
What’s more, as a report at that time in the online publication AuntMinnie.com put it, “The deal represents a validation of TeraMedica’s business model, which seemed like a radical idea when the firm was launched in 2001. At the time, PACS vendors had a hammerlock on medical imaging data, and the idea of an imaging facility moving its archive to third party was rarely considered. Since then,” said the report, by AuntMinnie’s Brian Casey, said, “the PACS-central model of data management is increasingly being viewed as a legacy architecture, and more PACS vendors are trying to position themselves as VNA providers—with varying levels of success. For its part, TeraMedica evolved into the last remaining large, independent player offering VNA services, with an installed base of 300 customers around the world, according to Greg Strowig, chief operating officer of Fujifilm TeraMedica.”
The next two years really are going to be a fascinating time in the imaging informatics market in the U.S. and globally. Faced with conflicting dynamics, from reimbursement cuts and regulatory mandates on the one side—including the requirement beginning in 2017 that ordering physicians make use of clinical protocols in ordering diagnostic imaging procedures—and the need to move forward to capture market share in tightening local and regional healthcare markets on the other—the leaders of patient care organizations will need to look very carefully at any moves they make in this arena.
And the stark reality for PACS vendors is that the expansion possibilities are very limited at this point in most urban healthcare markets in the U.S.; and that the commoditization of PACS as a solution continues to proceed apace, particularly as VNA and enterprise-wide imaging informatics architectures become more and more commonplace. Still… there must be a few more villages in Nunavut that are in the same position as Iqaluit. But vendor salespeople had better put their parkas and lined boots on pretty quickly and get on flights up to those villages, because, with the increasing universalization of diagnostic imaging procedure access even in very remote regions—a very laudable thing—there are a dwindling number of such villages left to scout out.