From the January/February 2022 issue of HealthCare Business News magazine
Many vendors are shifting to offering a subscription model. This reduces the upfront capital expense for buyers, but increases their operating expenses. The finance process of some enterprises are not prepared for this shift, while others (those with limited capital now) welcome it.
One obvious advantage of subscription models is that the cost of the solution scales with the business; costs are correlated to the number of exams acquired (and, thus, revenues) each year.
Some aspects for buyers to consider are whether:
• Imported exams (no revenue) count as part of the per exam subscription fees; this is an important and often under-discussed topic.
• Enterprise imaging content (often with no revenue) stored also counts as an exam
• There are terms defining limits on per-exam cost increases over time
Other observations and trends
Here are some other thoughts on imaging IT:
• Academic radiology is increasingly investigating the option of providing subspecialty reading to other enterprises than their own. Affiliated hospitals that are dissatisfied with their private reading group often express interest in contracting with an academic radiology department to provide these services. They are interested in imaging IT solutions that support this type of cross-enterprise reading without having to install PACS (and reporting and other solution) clients for each hospital.
• Organizations are looking into new options for automating imaging exam data importation using an HL7 FHIR API provided by their EMR to auto-generate an appropriate order to link to the imported images. While not as captivating a solution as one based on AI, solutions like this will save millions of hours of manual effort across health systems.
• At RSNA 2021, I found startup companies build new PACS solutions. I have often felt that there were already plenty of options available in a mature marketplace (like the U.S.), where replacement and consolidation are the remaining growth opportunities. At first, I questioned the wisdom of this investment, but many large imaging modality and IT companies have a habit of failing to foster and deliver innovation, opting to acquire companies every so often to provide something appealing to customers. With disruptive technologies like web, cloud, and AI, a startup needs only to reach a reasonable level of maturity and adoption and they can expect a larger company caught flat-footed to get out their check book. Of course, the pace of innovation will die shortly after acquisition (life in a big company is not what attracted the talent to the company in the first place, and leaders have cashed out) and the cycle will repeat.
About the author: Don Dennison, CIIP, FSIIM, is a consultant that has worked in the medical imaging informatics industry for over 15 years. A Fellow of the College of the Society of Imaging Informatics in Medicine (SIIM), he is a frequent speaker and panelist at SIIM, RSNA, and other conferences on topics ranging from medical imaging record interoperability, integration of imaging data within the EMR, multifacility integration, and others.
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