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Last week Amazon made clear its intentions in medical imaging, announcing two new capabilities in HealthLake focused on medical imaging and analytics.

The Seattle-based tech firm says that the abundance of data created in medical imaging is slowing down decision-making in hospitals. In response, the cloud vendor has launched Amazon HealthLake Imaging, which is designed to expedite medical imaging retrieval in clinical workflows, as well as powering existing medical viewers and analysis applications. This, the vendor claims, can result in considerable cost savings.

However, with Microsoft’s Nuanced-derived healthcare expertise, Google’s recent moves into medical imaging, and Oracle’s inherited incumbency via its Cerner acquisition, has Amazon done enough to win the interest of providers?

The Signify View

Tech giants’ interest in healthcare is nothing new. Amazon, like other Nasdaq darlings, has made various approaches to different healthcare markets over recent years, from the launch, and subsequent shuttering of Amazon Care, a primary care service, to its Amazon Pharmacy play. Recently however, several of the world’s biggest tech firms have redoubled their focus, setting medical imaging firmly in their sights. After Microsoft’s acquisition of Nuance, which closed in April 2022 and Google’s recent launch of its Medical Imaging Suite, Amazon has become the latest tech firm to make a concerted imaging effort.

Like Google’s launch before it, the launch of Amazon AWS’ HealthLake Imaging suite is not festooned with brand-new, never-before-seen capability. Instead, many of the tools and partnerships included in the package have been available previously in various guises. However, the new packaging highlights Amazon’s increasing focus on selling cloud services to acute and outpatient providers as interest in, and understanding of the technology increases. While many of the tools have been previously available, it would likely have taken an already knowledgeable user at a provider to capitalise and work out how best the range of tools offered by Amazon could be applied to their own imaging departments. The packaging and positioning of Amazon’s latest effort, however, should help providers more clearly appraise the potential of cloud adoption for their imaging departments, easing the transition for more mainstream providers.

Such positioning, however, is only enough to make AWS more accessible. What Amazon hopes will encourage providers to commit, is its boasts about price. In its blog detailing the new solution, Amazon estimates that HealthLake Imaging helps reduce the total cost of imaging storage by as much as 40%.

The Cost of Delivery

This figure, as is often the case with those used in marketing materials, should be taken with a pinch of salt. No doubt Google, Microsoft and other cloud providers harbour some technologies which are also designed to help reduce the cost of storing images on the cloud. However, the fact that Amazon has publicly stated the savings that providers can expect indicates the vendor’s confidence in its ability to offer providers an affordable option.

Cloud adoption, can, after all be stymied by the cost, or at least perceived cost, of making the transition. While this is less of an issue for flagship academic providers and the premium they are willing to pay to have the latest and most experimental technology, for the acute and outpatient providers, cost is a far greater barrier. If Amazon is to truly capitalise on the revenue-making potential that cloud provision in medical imaging offers, however, this mass market is ultimately where the vendor must target.

By highlighting the cost-savings providers can expect to make if they adopted Amazon’s imaging cloud solution, even if the actual savings delivered are not quite at the quoted 40%, the vendor hopes to overcome the perception that cloud is prohibitively expensive, and at least engage mainstream providers in a conversation.

Even with such savings, cloud could still prove too expensive, depending on the volume, complexity and standards of the data held by the provider, but, crucially, these factors stem from providers’ individual circumstance. Moreover, the shift to cloud for imaging can also require substantial investment in network infrastructure (e.g. local bandwidth) to leverage the benefit of cloud-based performance.  While there will be providers for whom AWS’ HealthLake Imaging product is still too expensive, the advertised and expected cost savings, will likely be enough to convince some providers, particularly when other factors, such as cybersecurity or the requirement to deliver capability across complex outpatient networks, for example, are considered.

Choosing Between Sellers

At present, the key differentiators between cloud providers are still minimal. While different providers may have different strengths, individual niches where they excel and particular partnerships that will ease certain use cases, any of the major cloud providers can, in essence, offer almost the same broad capability in cloud services for imaging. However, despite this comparability, leading cloud vendors are still beginning to better arm themselves and shape their identities in an attempt to build links to certain customer bases. Amazon’s focus on efficiency and the cost savings it offers is one such strategy, a play that, as highlighted, stands to place cloud capability firmly in the reach of acute and outpatient providers.

Other cloud providers also have their own strengths, however. Microsoft’s Azure finds itself in a particularly strong position, largely thanks to its acquisition of Nuance. Most obviously, that acquisition gives Microsoft a direct line to a claimed 77% of hospitals in the United States. However, that acquisition also fits in with Microsoft’s broader portfolio. It is, after all, not difficult to see the possible synergies with Nuance’s Powerscribe solution (and nascent, yet impressive DAX ambient reporting), combined with Microsoft’s ubiquitous tools, including Teams videoconferencing. This could bring ambient listening to all consultations and telehealth visits, leaving essentially every interaction structured and stored on the cloud along with relevant medical images.

Google, meanwhile, may lack the Nuance play that Microsoft can lay claim to, and it may lack the relentless operational focus that Amazon has developed through its commerce heritage, but its expertise in search, AI and broader image analysis, will give its own strengths, making it, for example, an attractive provider for leading academics focused on using their data libraries to develop their own AI algorithms.

Expected Arrival

In most cases though, these are concerns for the future. At present many providers aren’t considering long-term population health-focused imaging data repositories in the cloud, or developing their own AI tools. Instead, most providers are looking to the cloud for improved accessibility, efficiency, security and cost.

With these basics amply covered by all leading cloud providers, at present, which cloud provider hospitals choose is likely to depend more on customer-context, rather than unique capabilities. It doesn’t necessarily matter, for example, if a radiology department harbours a desire for an AWS imaging IT platform deployment if it is part of a large hospital network, which has just agreed an enterprise-wide deal with Azure. Almost all leading Imaging IT software vendors have some degree of flexibility on cloud-provider for hosting their applications, making cloud adoption often an enterprise, as opposed to departmental, decision.

By a similar token, hospitals in regions where there are restrictions on public cloud provision, where there is a preferred partner or a requirement for in-region datacentres, for example, have needs that trump any smaller local preference for individual cloud providers.

Despite these considerations, there is one area where AWS might have an advantage. AWS has arguably worked its way into a broader group of informatics partners (and larger market share) as “preferred” cloud provider, than some of its chief competitors. While some providers will disregard the partnerships their IT vendors have fostered, for many, simply adopting their imaging IT vendor’s preferred cloud provider partner will prove to be the most straightforward route to transition to the cloud, and as such, all else being equal, will be the one that is chosen.

There are some factors that will become increasingly important over time, such as the ability to manage and retrieve unstructured data, the ability to offer analytics so providers can use their cloud resource most efficiently, and even the adoption and ingestion of different data standards from across an enterprise imaging platform. However, in the near term, such subtleties are far from a provider’s priority.

In the near-term one of the main priorities, particularly for many mainstream providers, is cost. As such, Amazon’s claims of cost savings along with its repackaged and repositioned offering may make it an obvious choice for some. And for now, when fresh, first-time opportunities abound, that should be enough for the Seattle-based tech giant to deliver.

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This Insight is part of your subscription to Signify Premium Insights – Medical Imaging. The content is only available to companies that have subscribed to this paid-for service. To view other recent Premium Insights that are part of the service please click here