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RSNA Day Three: A Question of Perspective

December 3, 2008
by Mark Hagland
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In an imaging management vendor market facing industry change and economic uncertainty, what’s the best corporate configuration? Is it better to be a “combination” PACS/RIS vendor, one that encompasses both a “modality” component (meaning that the company manufactures CT, MRI, ultrasound, and other diagnostic imaging equipment) as well as IT products (meaning PACS and RIS)? Or is it better to be solely focused on the IT side?

Not surprisingly, in meetings at the RSNA Conference today, vendors in the former situation extolled the benefits of being able to offer modalities and information systems together in the current economic and purchasing environment, while those without modalities took an opposite view. Indeed, senior executives from two of the first type—the Amsterdam, Netherlands-based Royal Philips N.V., and the Barrington, Ill.-based GE Healthcare—emphasized in meetings today with Healthcare Informatics their distinctive advantages as comprehensive imaging and information providers; while those from the Alpharetta, Ga.-based McKesson Corporation, an example of a non-modality provider—offered very different perspectives.

Sybo Dijkstra, senior marketing director of Philips Healthcare Informatics (based in Andover, Mass.), told Healthcare Informatics that “You can find more effectiveness and efficiency in your radiology department in optimizing the care process; providing alerts is one example. Advanced use of information in all the individual steps of care in collaboration with alerts and communication tools, can make the radiology department more effective; that’s what will be happening in the coming years. You need to look at how it all works together—the modalities and the information systems—in order to optimize care and efficiency; that’s where the emphasis will be.” Dijkstra also cited the flexible, web-based service delivery model if Philips iSight system.

Just steps away, however, George Kovacs, director of product marketing for McKesson, said firmly, “The market is recognizing that buying modality-based departmental systems is simply not the way to go.” In fact, Kovacs said, “Those vendors that use IT as a loss-leader in order to sell modalities aren’t going to be successful in that strategy any longer. The reality,” he stated, “is that any radiology director worth their salt wouldn’t buy their CT and their MRI from the same vendor, because they actually need to put their vendors into a bidding war” in order to win out as a customer. “And that extends to modalities versus IT: you want a vendor that focuses on making your operations more efficient and not on sliding something in, in order to slide in another modality.” In fact, he contended, some of the modality-driven vendors are disadvantaging their positions in the market as IT vendors by trying too hard to use IT sales efforts to push modality sales.

Meanwhile, steps away, Cristine Kao, senior marketing managing imaging solutions/integrated IT solutions at the Barrington, Ill.-based GE Healthcare, said that the watch-phrase going forward is going to be “clinical value.” The fundamental question for all vendors on both sides of the product category divide, modalities and IT, she said, is this: “It’s about positioning your solutions to address specific needs in healthcare, such as cost control, quality improvement, and so on. And it takes continuing innovation to reinvent yourself in order to continue to provide the clinical value.”

Of course, things are far more complex than the question of “solely IT versus modalities-plus-IT” implies. One CIO we spoke with said she was very comfortable with her situation, in which her hospital system’s modalities, PACS, and EMR are all supplied by different vendors. But it will be very interesting to see how all this shakes out, particularly in a PACS/RIS market that in the U.S. and northern Europe has become primarily a replacement market (though the largest PACS vendors, at least those with international reach, including GE, Philips, and McKesson, are looking to sales growth in emerging markets to help offset any major U.S. sales downturn in the short run).

More worrisome, however, is the future of any number of smaller niche PACS and RIS vendors exhibiting at RSNA 2008. How many of those firms will be around a year from now? Two? Three? Several years from now? Sales executives at the largest companies aren’t hesitant in predicting the early demise of many of their smaller rivals. McKesson’s Kovacs, for one, was straightforward in declaring the era of the smaller niche vendor to be pretty much over.

But who can say? As RSNA 2008 moves toward its close, one can only speculate as to the near-term future of PACS, RIS, modality, and combination vendors across the industry. Certainly, it will be fascinating 12 months from now to look at the RSNA 2009 exhibitor list and compare it with this year’s.

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