With this explosion in both market share and technology, investing in a new PACS system in the next four years may require even more due diligence for a CIO, in addition to keeping an eye on trends.
Justin Davidson, author of the Datamonitor report, sees hospitals moving into next-generation solutions like cardiology, pathology, ophthalmology — and outside the hospital into research.
But if the future is an imaging system for more than radiology, and as the biggest vendors buy up smaller PACS startups, will vendor consolidations make an initial PACS purchase a one-shot deal? “Some vendors may offer solutions for both radiology and cardiology, but the key point is that it's the integration that's becoming more complex,” Davidson says.He does not believe vendors are yet offering enterprise-wide solutions, but sees that as a growth area in the coming years.
Michael Gray of Novato, Calif.-based Gray Consulting agrees that consolidation of applications, contrary to many vendor claims, is just not there. “In truth,” says Gray, “there is really no one radiology/cardiology PACS. They're really separate applications — even though they may be sold as one system and marketed by the vendor as such. No matter how much homework you do, you still need to migrate data.” Bottom line? “You may be buying two systems, but the important thing is not to have to buy two archives,” Gray says.
Davidson agrees that a single archive is important — but getting on board immediately is even more critical. He believes waiting to install a PACS, even for less technologically savvy hospitals, is a mistake. “Hospitals that don't have PACS are not as competitive. While PACS technology is advancing all the time, it's not necessarily ever going to get to the stage where you have to replace it completely. It should be upgradable.”
But Gray believes the PACS market may be one area where the laggards have won. “There is an economic advantage for late adopters in PACS,” he says. “It's taken market pressure combined with reduction in prices, but it's less expensive to buy the same system today than a year-and-a-half ago.”
Davidson says those days are over: “They may not be losing out yet, but they will be.” The downside to the “wait-it-out” strategy is losing physician satisfaction in today's competitive markets, he adds.
Both agree that even smaller and less IT-savvy hospitals need to be in the game.
According to Davidson, the proliferation of PACS may lead to another important trend —overseas outsourcing. He believes it's especially relevant in the U.S. market where demand for imaging procedures is skyrocketing, in particular because of the upswing of chronic diseases like obesity and heart disease.
“The advantage with overseas outsourcing is that a hospital can go to India and write the report overnight,” he says. “Though it may be just one part of the full radiology report, reading the image overseas is now a possibility.” Davidson says this trend is still in its infancy, though it may become more attractive in the next few years. “It's an easy way to meet demand, and if demand falls, the expenditure doesn't change,” he says. “It doesn't have to be overseas, either. It could be doctors on the other side of the country. What's really interesting is that it offers real flexibility to institutions.”