Earlier this year, KLAS put out a report on the ambulatory RIS/PACS market that summed up the sector's mood thusly: "Waiting for the other shoe to drop." The first shoe, explains Ben Brown, GM for medical equipment & imaging informatics at KLAS and a coauthor of the study, dropped back when outpatient imaging reimbursements were cut, and providers had to scramble to reduce costs accordingly.
The second shoe is still yet to fall. But in both inpatient and outpatient settings, imaging professionals are "trying to figure out what meaningful use means for radiology," says Brown.
"Whether radiology or imaging becomes a formal part of meaningful use criteria in Stage 2 or Stage 3, or more reimbursement cuts around Medicare and Medicaid, I think those are other potentialities that could throw kinks in the market," he adds.
Another thing both sides of the equation have in common: a craving for integration. With Epic and Cerner, among the biggest winning deals in the hospital space in recent years, "integration with the EMR … has been a big driver for more RIS deployments on the hospital side," says Brown. "Having all the data patient information in context clinicians need around imaging, I think, has driven usage and improved it.”
Likewise, on the ambulatory side, "when there is very tight integration, there is a higher level of satisfaction," he says, "even though a product may not be perfect and have all the bells and whistles." Tight integration leads to a more effective workflow – something that's hard to put a price on.
"Whenever you have a lot of interfaces, it means you have more IT resources and needs to manage those interfaces, making sure they're working and flowing more smoothly and not breaking, with data being transferred to the right places," reasons Brown. "But when it's integrated onto a single platform, you just don't have as many of those challenges to worry about."
As for those who might be walking the exhibit floor at RSNA, perhaps looking to part with some money, Brown suspects radiology directors, especially those who work for large hospitals, will be looking for systems with "really high-end functionality."
When it comes to replacements systems, KLAS has noticed the "very high-end" market heating up, he says, with "having the right technology first" – as opposed to lower price – the primary driver.
But in the ambulatory space – specifically the radiology practice space – the focus is slightly different: grabbing stimulus money and avoiding subsequent penalties. There's a lot of interest right now in RIS or workflow tools that are meaningful use-certified. A number of big-ticket vendors are currently certified, and Brown predicts many others are going to unveil "modules that can be added to their PACS or certification of a RIS product that will allow them to certify and qualify for Stage 1 of meaningful use."
Sector-wide, "I think the future is bright," he says. "But as with a lot of healthcare reform, there are a lot of question marks about where the industry is going to go."
