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In just 80 days (that’s right industry marketeers, it’s time to engage post-vacation panic mode), the global radiological community will descend on Chicago for the 104th Radiological Society of North America Scientific Assembly and Annual Meeting. Viewed as the pinnacle for new product launches for medical imaging, the exhibition floor at RSNA also offers a glimpse of the future and a reflection of the state of radiology today.
Here’s our take on the top trends we expect to see taking centre stage at the show this year:
Efficiency, Efficiency, Efficiency
While you might have been expecting Artificial Intelligence (AI) to be first on our list (more on that below) we think efficiency will be the most impactful theme at RSNA this year. With health providers under pressure to deliver high-quality services to more people at lower cost, radiology is increasingly going to be under the microscope as an area for providers to make operational efficiency gains.
Don’t expect efficiency to be blatantly emblazoned across a single product or marketing campaign though – this is not going to be a headline grabbing theme. Instead, it will be subtly woven into almost all aspects of hardware and software on show, the impact of which is dependent on multiple small marginal gains. New imaging hardware released at the show this year will be that bit faster than the last; technicians will have to do less manual preparation and positioning; power consumption will be improved; repeat scan rates will fall; systems will boot up faster; service downtime will be reduced.
In software, new operational efficiency tools and modules will take centre stage. Either embedded in existing platforms or as add-on practice management modules, smart worklists, case-load balancing, QA support and a myriad of nuanced changes are being implemented to help the shrinking pool of radiologist resource do more in less time, with higher quality results. Operational analytics will also be prominent, supporting improved visibility and measurement of radiology department performance and creating a new market focused on “operational decision support”. Consolidation of health providers has created demand for long-term risk-sharing contracts with large vendors. Profitability for the supplier is dependent on improvements in clinical and operational performance at the provider. By expanding into the operational and administration budget of providers, big healthtech vendors see this as their next big opportunity for growth of professional services, on top of their ongoing hardware and software supply revenue streams.
Enterprise Imaging Comes of Age in Two Distinct Flavours
Enterprise imaging, while not a new topic in radiology, will again play a significant role at the show this year. At its formation, radiologists’ concerns over the potential loss of control of their PACS and RIS to encroaching enterprise health IT systems such as EMR and HIS, were most prominent in limiting the term “enterprise”. Yet today, enterprise imaging has become a catch all for confusion and vagueness, not helped by every imaging IT software product on the market being branded as enterprise imaging.
At the show, we can separate enterprise imaging into two broad categories. The first, essentially “Enterprise Radiology” has come about with consolidation of health providers and radiology practices into larger radiology enterprise networks. Its genesis, often supported by enterprise VNA implementation to integrate data from various proprietary PACS systems into a single repository, also provided the opportunity for integration and exchange of non-radiology unstructured clinical content (e.g. non-DICOM). Though, few implementations with a Radiology Enterprise focus have matured to provide access outside of core diagnostic imaging. This area has also become more introverted with the growing availability of modules and add-ons to support operational efficiency across the network (as described above). Consequently, the bulk of implementations have been tied to single vendor offerings, with limited interoperability outside of radiology.
The second category, better described as enterprise clinical content, has focused more on access and interoperability of both structured (DICOM) and unstructured data across multiple clinical departments. While often driven from radiology, it has used more mature clinical archive and content management software to enable broader access to imaging and associated clinical content across the broader clinical network. This has also been tied to the shift in healthcare provision to integrated care and diagnosis, such as supporting multi-disciplinary tumour boards for cancer patients.
Both flavours of enterprise imaging will be prominent at the show, though come with a word of warning; rarely are the two types so obviously discrete as described above. Some enterprise radiology solutions on show will have capability to support non-DICOM content, albeit not in native format, but will still boast of enterprise clinical content capability. Vice-versa, some enterprise clinical content vendors will boast of the full enterprise radiology capability yet lack the maturity of diagnostic and workflow tools offered by specialists. Over time, both will at some point converge, but until then, enterprise imaging will remain a confusing segment to decipher.
Stuck in the Middle
Consolidation of healthcare providers and the push for integrated care are also having a profound impact on the vendor make-up of the show floor, which we expect to be more evident in 2018. Above all, mid-sized vendors are becoming increasingly scarce and their presence at the show will be diminished. Hardware vendors with only one or two modalities will find it increasingly difficult to compete. Consolidation of health providers to larger enterprises will favour the largest vendors that can offer a full portfolio of imaging modalities, especially as procurement preferences move towards longer term, bundled managed service deals. Moreover, with the ongoing drive to efficiency, there are now fewer differentiators between imaging hardware products, creating a more price-competitive market. Again, this favours the larger vendors that can swallow short-term price drops over long deals.
In software we expect a widening polarity of vendor scale, between platform vendors and best-of-breed specialists. Again, the mid-sized vendors with smaller platforms or partial portfolios are at risk. Expectation around interoperability and simplifying supply chains is pushing most larger healthcare providers away from multi-vendor software implementations, towards single platform solutions. Almost all will be marketed as “ecosystems”, though few have yet reached maturity in interoperability or extensive third-party application partnerships to replace the current patchwork of applications used by most health providers. At the opposite end of the scale, a raft of small best-of-breed specialists will fill the show floor space left by shrinking mid-size vendors. Most are there not to sell their wares but build valuable partnerships with clinical leaders and leading platform vendors. Amongst this group will also be where the most innovative technology and applications will be seen at the show, whether in AI, workflow tools, practice management or advanced visualisation. However, many won’t make it to the show next year, such is the challenge of market entry.
Progress and Disguise
Of course, AI will be a dominant theme at the show this year, though with a different focus to previous shows. The fear of radiologists being replaced by AI has subsided (for now), with growing anticipation that AI can instead augment and support radiologists coming to the fore instead. Clearer categorisation of AI will be more evident too.
In terms of the number of solutions, AI-based quantification and measurement tools will be best represented, and more comfortably accepted by the radiologist community attending. Those with clinical validation and real-world evidence to support their pitches will be the attention grabbers. We should also expect to see more examples of these tools being integrated into larger imaging IT software platforms. Many of these tools will also be actively promoted by vendors pushing the “marketplace” model and pay-per-use options.
Clinical decision support tools, while less abundant, will also have a significant presence, though should be approached more cautiously. Few solutions have so far managed to gain regulatory approval or will have formed partnerships with larger imaging platforms. Regardless, interest in these solutions will be highest, as they point towards how augmented radiology might work in the future. Work in progress demonstrations will be at every corner, with the heaviest focus around lung, neurology and liver imaging. Discussion will also focus on availability of data for algorithm development and the complex ongoing challenges surrounding data protectionism, commercialisation of de-identified patient data sets and broader interoperability of health data.
Consequently, computer aided diagnosis (CADx) could well take a back-seat at RSNA this year. Most solutions in development are some way off making it to market, and the select few that have approval are single application and single function focused, thus a long way off from the all-encompassing CADx solution that radiologist feared may one day replace them.
Use of AI to support workflow and operational analytics will also be more obvious on the show floor. Auto-triage and associated smart worklist algorithms based at scan acquisition will be prominent from the larger modality vendors, pointing towards a growing use of computing power at the edge in radiology, assisted by wider availability of GPUs. AI-based workflow support tools will also become more widely available, focusing on intuitive and adaptive user-interfaces and retrieval of diagnostically relevant patient information from outside of radiology. However, it is at the intersection of operational and diagnostic processes where use of “AI” will be over-zealously pedalled, with basic machine learning and computational techniques that have been available for years being pushed as “AI-driven”.
Signify Research at RSNA 2018
Our expert team of market analysts will again be travelling to Chicago for RSNA 2018 and look forward to the opportunity to meet with vendors, providers and industry stakeholders for:
- Discussion on specific market topics and trends
- An introduction to the Signify Research team and our market intelligence solutions
- Briefing on our most recent market findings and data
- Provide a vendor briefing to our analyst team on your latest products
- Participation in our syndicated market reports
- Interest in press and media collaboration
- Finding out if we were right with the above predictions!
- We look forward to seeing you in Chicago!
About Signify Research
Signify Research is an independent supplier of market intelligence and consultancy to the global healthcare technology industry. Our major coverage areas are Healthcare IT, Medical Imaging and Digital Health. Our clients include technology vendors, healthcare providers and payers, management consultants and investors. Signify Research is headquartered in Cranfield, UK.
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