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ECR 2019 was a particularly special conference as it marked its 25th year anniversary in Vienna. While I was disappointed to miss the philharmonic orchestra at the grand opening, I did get to experience a symphony of new product launches and the latest technological innovations the industry has to offer. From a classical general radiography perspective, the core themes of product innovation were an ensemble of advances across artificial intelligence, workflow optimisation, advanced clinical applications, ergonomic design, dosage management, image quality and IT infrastructure connectivity.
The global market for general radiography equipment is well established across most geographies and is anticipated to grow over the coming years, which these product enhancements will in no doubt help to support. Despite this positive outlook for the overall market, there will ultimately be individual gains and losses and, radiography OEMs as well as component manufacturers are facing the tough challenge of continuing to differentiate their solutions at favourable margins. This is in part due to significant changes to healthcare provision such as the shift toward value-based care, increased competition from new entrants, product commoditisation as well as the maturing of existing technologies.
The competitive landscape is compounded by a demanding global customer base with a diverse range of priorities and needs across healthcare systems. As a result, OEMs are strategically positioning themselves to capture market share through offering tiered product portfolios to meet the needs of specific customer segments. This has led to “premium” and “value” systems, whereby the amalgamation advanced features and capabilities have become more indicative of system value. It was certainly clear at ECR 2019 that this type of product differentiation has become more widespread.
With the adoption of value-based care becoming more prevalent, equipment OEMs have been evolving their product portfolios to compete under these rules of engagement. Premium systems are now typically more focused on introducing product features and capabilities which seek to deliver significant improvements to a radiographer’s workflow (to reduce exam times) and to improve the effectiveness of an exam (to reduce time-consuming and costly repeat exams). These types of productivity and operational efficiency gains help vendors to monetarise system features during the sale process in order to fight price erosion or to help justify higher relative prices. Increasing system dexterity through integrating multiple imaging techniques, such as combining fluoroscopy and tomosynthesis with radiography, is also adding value through helping smaller healthcare providers to maximise the utility of their x-ray rooms or helping larger healthcare providers to manage peaks and troughs in the demand for x-ray services.
Improving diagnostic confidence through integrating advanced applications is also interconnected with this productivity and efficiency play. This is especially true for customers who are rewarded for making efficient use of resources and not squandering funds, such as accountable care organisations (ACOs). These types of product enhancements are proving to be popular in countries where fiscal budgets are constrained, in part, due to changes in reimbursement terms, increasing patient volumes from aging populations as well as growing public liabilities which can mean fewer financial resources are available to invest into capital equipment.
Better ergonomic design and motorisation, to help reduce repetitive movements and radiographer strain, have been a focus for recent physical product enhancements. Hardware improvements to FPDs and processing units in order to increase image quality have also been a feature. When combining these hardware enhancements with software algorithms for advanced image processing and image quality assurance (QA), material improvements to image quality can be achieved which is associated with improved diagnostic performance.
Product enhancements predicated on software has become increasingly important, particularly when geared toward delivering operational and productivity gains. For example, some OEMs are developing software solutions which seek to add value through better auto-positioning to reduce imprecise collimations, automating QA checks as well as making systems generally easier to use through intuitive and standardised user interfaces. As the capabilities of artificial intelligence (AI) technology becomes proven and scalable, this will enable OEMs to deliver significant workflow and productivity gains through AI-based applications for auto-disease-detection, diagnostic support aids and workflow prioritisation. It is possible to envision that software-based features become an increasingly important factor when differentiating premium systems in the short to medium term as well as protecting overall product portfolios from price erosion and market share losses in the longer-term. While there certainly is still a market for analogue and value digital radiography systems with less sophisticated software capabilities, those OEMs who underinvest into software features, may find themselves becoming increasingly marginalised within the premium markets throughout Europe, North America and China.
In response to the current competitive landscape and discussions with numerous OEMs at ECR 2019, Signify Research is conducting a research project to identify the global demand for general radiography and fluoroscopy equipment including FPD supply. This research seeks to highlight the current market structure through segmenting sales revenue and units by system value using features as an indicator of value. The research will also segment by customer type which will help our clients to identify the value of systems specific customer segments are purchasing across different geographies as well as identify the opportunity areas for future product development and sales revenue growth.
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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