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The global teleradiology market is served by a broad range of vendors, including international players with operations in multiple countries, and local vendors significant in their domestic country, many producing 100,000+ teleradiology readings of diagnostic images annually.
The teleradiology market consists of two key components – Teleradiology Reading Services and Teleradiology IT – the mix of company types falling into these components is illustrated below:
Just over 12 months ago, Signify shared its analysis on the supplier ecosystem. Whilst the competitive landscape has remained relatively stable since then, there have been examples of some younger entrants gaining prominence, and M&A activity involving leading vendors taking place. An update on several vendors within each teleradiology category and their recent market activity is explored below:
1. Full-Stack (Self-Developed Commercial IT and Reading Services)
Includes teleradiology reading service providers that have developed their own IT, which they use to support their own services and make commercially available for third parties to purchase. Example vendors include:
Doctor-NET
Doctor-NET is the leading provider of teleradiology reading services in Japan, and the third largest player globally, with an offering that includes diagnostic image reading, on-site (Doctor PACS) and cloud-based (Virtual-RAD) IT software, and AI interpretation services. Its network consists of 800 Japan Radiological Society (JRS) approved radiologists working as contractors, representing 13% of the country’s supply of radiologists.
DeepTek
Headquartered in the US, DeepTek is a full-stack provider of teleradiology reading services and cloud-based IT (PACS) platform with built-in AI tools (Augmento). DeepTek Pune is a subsidiary based in India, with a team of 55+ employees consisting of radiologists, data scientists and software developers. The majority of DeepTek’s revenue is generated from its India-based customers.
Most examples of AI adoption in the teleradiology market to-date have been with teleradiology reading service providers partnering with third-party AI specialists. This reduces the research and development burden on the teleradiology vendor and means they can just use the best solution available. However, DeepTek, is one example of the few vendors bucking this trend by developing teleradiology reading services and the associated AI in-house. Whilst it must carry developmental costs in-house, it will hope that in return it can produce a best-in-class solution, which is better integrated than those providers using a third-party’s software, and ultimately offer differentiation in the market.
Whilst not “Full Stack”, recent market entrant Nines is another teleradiology reading services provider that had developed its AI software platform in-house. However, as discussed in a recent Signify Premium Insight, Sirona Medical announced in March 2022 that it was acquiring the AI capabilities of Nines, suggesting that its AI tools were not having the impact Nines had originally hoped. Its offering will continue to include teleradiology reading services.
Philips (Direct Radiology)
Philips’ growth within the teleradiology market has largely been aided by acquisitions, namely the purchase of Direct Radiology’s teleradiology platform and reading services business in March 2019. Here Philips kept the reading service element of Direct Radiology as a separate entity but integrated the Direct Radiology IT into the broader Philips portfolio of imaging IT, allowing it to develop a strong competitive edge in the teleradiology IT market. Direct Radiology was estimated to be a top-10 provider of US teleradiology reading service volumes in 2020. Philips’ 2019 acquisition of Carestream Health’s Healthcare Information Systems (HCIS) business has also enabled it to strengthen its teleradiology platform offering; Philips was estimated as the third highest ranked teleradiology IT vendor globally in 2020.
2. Reading Service Provider (Self-Developed IT)
Includes teleradiology reading service providers that have developed their own IT, which they use to support their own reading services, although the IT is not made commercially available at scale to third parties. Companies that fall into this category include:
Envision Healthcare
Envision, a leading US provider of physician-led services, post-acute care, and ambulatory surgery services, made its entrance to the teleradiology market via acquisition; in late 2017 it acquired Imaging Advantage, a provider of radiology services including hospital-based, outpatient and remote-reading services. Envision makes use of its proprietary IT “Connect” software which includes AI-driven workflows, and relies on Intelerad for the provision of viewing software and cloud infrastructure. Its team of 1,250+ radiologists perform 12m+ reads annually, of which teleradiology reading represents over 20% of volumes. Envision is estimated to be the second largest teleradiology provider in the US, behind Radiology Partners.
ONRAD
US-based ONRAD supports 275 healthcare providers in 35 states and is estimated to be a leading specialist radiology service provider in the country. ONRAD uses its self-developed IT infrastructure (RIS) in conjunction with third-party PACS software to deliver its teleradiology reporting service. The vendor is a top-10 teleradiology provider with c. 1m read volumes performed annually in the US, and represents an even higher share of market revenues (top-5 vendor).
3. Reading Service Provider (Third-Party IT)
Similar to the above group in that it also provides reading services, although the IT platform is provided by third-party providers. Examples include:
Medica
Medica’s the largest teleradiology service provider within the UK & Ireland and one of the top 10 providers globally. Its core business strategy involves working in partnership with NHS Trusts (>100 hospitals), which are experiencing surging demand for diagnostic reporting, limited in-house capacity and ongoing financial constraints.
Much of Medica’s domestic market growth has been driven organically but over the past two years it has invested in M&A activity to drive its long-term objective of geographic expansion and penetration into new markets; it acquired Ireland’s only national teleradiology provider, Global Diagnostics, in late 2020, and in early 2021 launched a 50-50 joint venture called “MedX” with Australian teleradiology provider Integral Diagnostics.
Medica had historically used a combination of self-developed IT and off the shelf imaging IT from Terarecon, however in early 2021 announced that it had chosen Sectra to supply its PACS system, which was subsequently implemented in February 2022. The deal reenforces a longer-term market trend that increasingly teleradiology reading service providers are moving away from self-developed IT towards third-party solutions. There will still be many exceptions, and the transition will take some time. But the share of reading service providers using their own imaging IT solutions is forecast to gradually continuing to decrease.
I-MED Radiology Network
I-MED is Australia’s largest radiology network and one of the largest imaging providers globally, with clinics in every state and territory. In 2018 European private equity firm Permira acquired the group for AUD1.25 billion (USD0.93 billion) and has since supported I-MED’s acquisitions of local radiology groups. Teleradiology is a relatively small part of the overall business; I-MED performs almost 5m patient procedures annually, although emergency and after-hours teleradiology reporting from its ‚ÄòI-TeleRAD’ group represents around 10% of its annual volumes.
Fragmented Supplier Base
The fragmented nature of the teleradiology market means that most countries are dominated by local vendors. With the US representing by far the largest teleradiology reading services market revenues by geography (>40% global revenues), it is no surprise to see several US-based providers occupy more than half of the top 10 market share positions. Beyond these, providers from the UK/Ireland (Medica), Japan (Doctor-NET), Oceania (I-MED Radiology Network) and TMC/Unilabs (Europe) complete the list, shown above. However, there remains a long tail of vendors serving the market and accounting for approximately half of global market revenues. With 50+ vendors profiled in Signify’s Teleradiology market report, a detailed overview of the vendors representing a combined three quarters of global reading services revenue is provided.
4. IT Only
Includes IT vendors that sell either their standard imaging IT products or solutions tailored for teleradiology, to teleradiology reading service providers. These include traditional imaging IT vendors such as Intelerad, Fujifilm, GE, and IBM, and teleradiology IT specialists such as RamSoft and Meddiff.
Intelerad
Intelerad is a Canadian-based provider of teleradiology PACS, enterprise and workflow solutions. It features most prominently as a supplier of third-party IT for several teleradiology vendors, including Envision, Everlight Radiology, Vital Radiology Services, I-MED Radiology Network, and Integral Diagnostics.
RamSoft
Privately-held Canadian-based healthcare IT software and services company RamSoft provides >2,000 healthcare providers (radiology centres, ambulatory, and acute-care practices) with a platform to enable diagnostic imaging.
The vast majority of RamSoft’s teleradiology IT business supports its North American clients, including The Radiology Group (TRG) and Premier Radiology Services (both top-10 US providers). It also supports clients globally, including across Latin America, Southeast Asia, Australia, Africa, and the Middle East.
The vendor bolstered its product offering and customer base in July 2021 via the acquisition of Indian-based Meddiff Technologies, another leading teleradiology IT platform provider, with a global footprint that includes over 800 clients and 1,500+ installations.
About Signify Research’s Teleradiology Report
September 2022 will see Signify Research publish the third annual update of its Teleradiology World market report. The report will examine the penetration that teleradiology has made into the overall number of diagnostic imaging procedures performed globally, including the impact of the global pandemic, and, specifically, in 20 core countries and sub-regions. It presents our estimates and forecasts provided to 2026 for the market for teleradiology reading services (reading volumes, revenues, and revenue per read), teleradiology IT and the competitive environment (from a reading service provider and IT vendor volume/revenue perspective).
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.
For further information please contact Arun Gill.
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