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After the strongest hint yet from Prime Minister Theresa May that the U.K. will look to extract itself from the European Union (EU) single market (a so-called hard Brexit), it seems right to review early speculation on the outlook for medical imaging and healthcare IT.

Machine learning was undoubtedly one of the hottest topics in radiology last year, with a steady stream of academic research papers highlighting how machine learning, particularly deep learning, can outperform traditional algorithms or manual processes in certain use-cases.

Greeted with fiercely mild weather for late November/early December, the 102nd RSNA show already had the feel of being a bit different. Of course, there was the packed program of fascinating research and exhibition halls bursting with advanced imaging hardware and cutting-edge IT solutions. But there was also the growing feeling, perhaps spurred by the theme “Beyond Imaging,” that radiology is in a mode of transition.

Probably the standout from RSNA is just how big imaging informatics and clinical data management has become at RSNA. Boths

Artificial Intelligence was undoubtedly one of the key themes at this year’s RSNA, featuring prominently on the exhibition floor and in several scientific sessions. At least 20 companies displayed products featuring AI technologies and a handful more used AI as a key part of their marketing messages, even if the use-case wasn’t entirely clear.

At first glance of the RSNA 2016 exhibition floor, one may have observed little has changed in ultrasound, apart from the re-emergence of live ultrasound scanning demonstrations after a 27-year hiatus. However, if you managed to get away from talking about artificial intelligence and the future role of radiology, innovation in ultrasound was clearly on show, albeit more subtly.

November 21, 2016 – As many of us gear up for the annual pilgrimage to the RSNA meeting in Chicago, it’s safe to expect artificial intelligence and big data will be front and center of the exhibition. Perhaps less expected will be the abundance of visualisation software on display from a growing selection of exhibitors.

The application of machine learning in radiology is evolving at a rapid pace and whilst fully automated diagnostic systems are still several years away, there is a growing number of machine learning tools available now that are helping radiologists to improve their efficiency and to make better diagnoses.

The biggest positive for CompuGroup Medical is access to an established customer base in Western Europe and the US. CompuGroup’s core market focus and successes have been in Eastern and Central Europe to date, though recent acquisitions have expanded this reach. In contrast, AGFA has spent decades building a strong reputation as a clinical specialist in medical imaging, mostly focused on digital radiography X-ray and imaging IT software. AGFA’s sizeable healthcare customer base would therefore make an attractive target for CompuGroup’s EPR products. In Western Europe, a market relatively immature in EPR adoption, this offer significant growth potential. In contrast, the US market for EPR in hospitals is intensively competitive and dominated by major players such as Epic Systems and Cerner, limiting growth opportunity. However, the large and fragmented ambulatory and outpatient EPR market may be more attractive and could well suit CompuGroup’s products. 2. AGFA agreement would be an “all-in” move on healthcare AGFA’s Healthcare unit accounted for only 41.5% of its $2.6 billion revenue in 2015, with Graphics and Speciality Products making up the remainder. AGFA may well be looking for some assurances on the future of the non-healthcare business lines. However, CompuGroup is a pure healthcare focused company, so the Graphics business is unlikely to be viewed as an essential asset, and could be targeted for potential sell-off. If so, any deal acceptance from AGFA will essentially be an “all-in” move to focus on healthcare, mirroring the recent position taken by Philips, one of its major competitors north of the border. This will be viewed as a risk, given that the AGFA Healthcare business unit revenues have been stagnant in the last few years. However, when viewed in the wider market context, the healthcare sector is already a target for some of the largest technology and IT firms, such as Google, Apple, IBM and Microsoft. This confidence and investment therefore suggest it would be a risk worth taking. 3. Strategic mid- to long-term fit questionable On balance the deal appears more favourable to CompuGroup than AGFA. It offers market access to more mature and profitable markets and will add a strong brand focused on clinical excellence in medical imaging and imaging IT software, providing further credibility to its growing market presence in Europe. However, in context of the wider market, the deal would not solve the biggest strategic challenges for AGFA. As a well-respected mid-sized firm entrenched in medical imaging hardware and software, the focus for AGFA should remain in driving clinical excellence in its core field of diagnostic imaging. Expansion to cover EPR and a new Eastern European customer base could drive some short-term revenue growth for both its software and hardware product lines. However, the joint EPR of an AGFA- CompuGroup deal would unlikely concern the major EPR or enterprise health IT vendors, so over time would offer little in terms of long-term growth potential. Moreover, most market growth and disruption is in the enterprise health platform segment, especially for population health management, analytics platforms and cognitive computing, a challenge for a firm of AGFA’s size to compete in. Instead, AGFA should look to expand its reach within the clinical realm, focusing on applications where its expertise in clinical software and workflow can have most impact, especially in applications relatively new to digitalisation, such as Pathology. It should also look more to associate and partner in provision of new business models, service, cloud technology, cyber security and cognitive computing (much like its recent association with IBM Watson Imaging collaborative). So, unless CompuGroup is willing to pay a premium for AGFA, the likelihood of a deal given the challenge of the Graphics business and poor long-term strategic fit of the healthcare assets is relatively low. Share on LinkedIn Subscribe to our free monthly newsletter with our latest market insights

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iemens Healthineers is the latest major health technology firm to announce an involvement with IBM Watson Health, following AGFA Healthcare being part of the IBM Watson “Medical Imaging Collaborative”, while Medtronic and Johnson & Johnson have partnerships for PHM.