The RSNA annual conference, sponsored every year by the Radiological Society of North America and held every year at the vast McCormick Place Convention Center in Chicago, is always a study in contrasts, on many levels and along many dimensions.
When it comes to some of the large vendors in the imaging informatics space, the situations of the Malvern, Pa.-based Siemens Healthcare and the San Francisco-based McKesson Corporation are a quick study in apparent contrasts (though the situation below the surface is slightly more complex, as is always the case). This fall, Siemens announced it was selling much of its U.S. healthcare IT business to the Kansas City-based Cerner Corporation, in a kind of partnership in which Cerner is taking on the assets, with continued participation from Siemens executives and staff; at the same time, the company is expanding its syngo line of products and services, which will naturally buttress its ongoing imaging modality operations.
At the Siemens media breakfast and press conference on Dec. 1, Hermann Requardt, the CEO of healthcare for the entire global Siemens corporation (with healthcare operations based in Erlangen, Germany), said, in response to a question from Healthcare Informatics, the following regarding Siemens’ sale of healthcare IT assets to Cerner: “It’s not healthcare IT we sold, it’s hospital information systems. The realization was that the potential for product offerings for us was in a different arena. So having an ERP system in hospitals doesn’t necessarily help you sell more MR scanners. It’s simply an isolated business,” he said, referring to the U.S. electronic health record systems (EHR) business.
“We will focus our IT capabilities in areas where we can leverage our offerings,” Requardt continued. “So, next-generation healthcare IT—we will leverage that to promote utilization and optimization of our offerings. The HIS business was not very helpful in that regard. And that market was heavily consolidated, and we would have to invest a great deal of money to succeed in the U.S., in a heavily consolidating market. After all, 70 percent of the U.S. HIS market is now in the hands of two companies. So,” he concluded, “I’m quite satisfied that we’ve created a partnership with Cerner. And everyone here, including the shareholders, was happy with that transition.”
Of course, Siemens’ sale of its EHR and EHR-related business lines does not signal a retreat from imaging informatics altogether. Indeed, on the same day of the media breakfast, Siemens Healthcare announced the appearance of a new solution called “teamplay,” “a cloud-based network…that helps link hospitals and healthcare experts to provide them with the ability to exchange data and pool their knowledge. Within hospitals,” the press release stated, “’teamplay’ makes it possible to evaluate the extensive amount of information generated by imaging devices—e.g., scanner capability utilization, examination times or radiation doses—and to compare the numbers against in-house and third-party reference values. This means imaging devices can be analyzed in close to real time and their operation optimized based on the results, right down to individual device level.”
Dr. Marc Lauterbach, vice president of marketing for SYNGO, the business line within Siemens Healthcare that will remain with the corporate fold after the Cerner deal closes, provided HCI with a demo of the product and said that Siemens execs expect about 100 hospital organizations in Germany and the U.S. to become involved in the piloting of teamplay in the summer of 2015, and eventually, expect thousands of patient care organizations to become involved, potentially creating a massive database for outcomes benchmarking. The teamplay product/service fits perfectly into the company’s strategy to continually enhance its syngo capabilities and support its ongoing imaging (modality) operations.
Meanwhile, McKesson executives see opportunities in data analysis, too, and are moving forward in a number of different directions. George Kovacs, executive director, Product Marketing, in McKesson's Imaging & Workflow Solutions business unit, told HCI on Sunday that healthcare IT leaders are on the cusp of a true revolution that will change the relationship of the practice of radiology to the rest of medicine, and to society. “The real challenge,” he said, “is to figure out how figure out how to get radiology to live up to its real potential. And diagnostic imaging looks like an expensive specialty, operationally speaking. But from the patient care standpoint, everybody knows it’s best to catch things early on; that actually saves money. So the issue isn’t that we’re doing too many diagnostic imaging studies, it’s that they’re too expensive.”
Fundamentally, Kovacs believes, what needs to happen is to leverage the clinical data embedded in radiology processes to analyze and improve clinical outcomes. “We finally have the technology to mine data,” he said. “We no longer need to simply slavishly digitize what used to be analog workflows. We’ve been doing that for decades. But now we have the capability to update the people and processes involved. And there’s enough data in the world of case managers and care managers that they can finally bring their discipline to bear across a whole enterprise.”
The next step, then, Kovacs believes, is to create “more value. Which cancer patient would not donate their anonymized images for the befit of better patient care? And if you depersonalize, you have data,” he said. “So if you have the data and IT means to pull all that together, and you let a small army of PhD students loose on it, what would we learn?” In short, we would learn through analysis which care approaches and interventions were the most efficacious. For example, he said, “Everybody follows the same routine of doing ultrasound first, doing an x-ray if that isn’t conclusive, then if that isn’t conclusive, doing a CT. And ultrasound is cheapest. But you introduce delay to the process. And risk goes up with it, because there could be a ruptured appendix, for instance. And yet, if you expand your view beyond radiology to the entire care process, saving bucks in radiology may not make sense if you calculate the cost of wasted OR time.”
So the very kinds of big data analysis-based strategic changes in imaging delivery could be coming soon, Kovacs believes. And investing in workflow intelligence capabilities, such as the quality workflow engine McKesson acquired through the purchase of what had been PeerVue, as well as further integration of the VNA [vendor-neutral archive] capabilities the company has continued to build, will only better position McKesson for the future.
As everything moves forward in healthcare, Siemens and McKesson executives, along with the senior leaders of all the healthcare IT, imaging informatics, and modality vendors exhibiting at RSNA, will continue to reframe and reposition their product lines and services to match ongoing changes in the market. And those involved in all these areas will find out soon enough how their strategies will have played out.
