Reflections on RSNA: Competing Narratives?

June 24, 2013
Now that RSNA 2011 is over, it’s a good moment to take a pause and think through this year's RSNA experience.
Now that RSNA 2011 is over, it’s a good moment to take a pause and think through the RSNA experience this year. I found my head swirling with the competing pitches of various vendor executives, and trying to sift through the various potential scenarios.

As I wrote two days ago, it was exceedingly helpful to consult with Joe Marion, one of the true industry thought-leaders in the imaging informatics area, on Wednesday, and to get his take on issues facing imaging informatics leaders these days. In that context, his blog on the vendor-neutral archive concept is not to be missed!

And then I had a particularly fascinating conversation Thursday morning with Barry Gutwillig, vice president-business development-technology at the Minnesota-based Virtual Radiologic, known as vRad. As did all the vendor executives I met with at RSNA this year, Barry had a very good pitch to pitch me regarding his organization’s vision for the imaging informatics marketplace. In addition, the vRad folks are evolving forward a very unusual, multi-partite strategy, one that could either prove wildly successful, or potentially backfire strongly.

To begin with, vRad a little over a year ago acquired Nighthawk, instantly becoming the market leader in the external-reads market. Then, of course, the vendor has its own PACS solution, now available in the cloud. And in addition, vRad is now pursuing a strategy of acquiring full radiology practices, having so far acquired practices in New York and Philadelphia. Barry Gutwillig told me he and his colleagues are looking at several other major metro markets nationwide for potential expansion of that strategy.

So the vRad folks are pitching their company as one that can provide external reads/teleradiology services; cloud-based, outsourced PACS storage and connectivity; and even full-service radiology group-based service to hospitals in local markets.

Meanwhile, in my previous blogs this week, I mentioned briefly the strategies of the AT&T/Accenture collaborative, known as the Accenture Medical Imaging Solution, which aims to offer providers with cloud-based, anywhere-available PACS viewing and image and data sharing; and my conversation with Andrew Litt, M.D., the new chief medical officer at Dell Corp. The executives of both of those vendors see tremendous potential in creating image and data storage and sharing capabilities untethered from traditional PACS and RIS systems, as they’ve been understood until recently, at least.

Not surprisingly, the executives and thought-leaders at the more traditional vendor firms with whom I spoke this week see the current landscape very differently. George Kovacs of McKesson, with whom I meet every year at RSNA (and often at HIMSS as well), openly scoffed at the idea that vendors coming into healthcare from the outside will ever be able to understand the complexities of image and data management across numerous medical specialties, in very complex patient care organizations. And George definitely has a point, one that can’t easily be dismissed.

Then there is an issue, which would most strongly affect those vendors working outside the traditional “PACS” sphere, but which ultimately could easily affect everyone, and that is the level of control that CIOs and other patient care organization IT leaders will need, as they respond to all the data collection, data reporting, and other requirements coming out of the meaningful use process and the various mandatory and voluntary healthcare reform programs. It’s one thing to embrace the cloud for PACS, but how does one really manage a tremendous data and image architecture when pieces of that architecture are effectively outside one’s day-to-day control?

In the end, it seems clear to me that only time will tell as to which strategy or strategies might be the most prescient, when it comes to the ongoing evolution of imaging informatics and clinical informatics more generally, in the years ahead. After all, the landscape for imaging informatics looked quite different even a year ago; so who can really predict what it will be like ten or even five years from now?

Still, all the vendors are having to take risks and move forward based on their best crystal-ball gazings, just as CIOs and other healthcare IT leaders will have to. I look forward to RSNA 2012, and to looking back a year from now on the year that’s coming.

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