Tag Archives: Command Centres

Signify Premium Insight: Keeping Faith in Mission Command

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This Premium Insight is the second in a two-part series assessing the impact and strategy of command centre solutions for the medical imaging sector.

The first part of this series, Establishing a Commanding Position, (available here) emphasised the strategic opportunity that command centre solutions presented large international medical imaging vendors for increasingly embedding themselves in hospitals’ imaging departments. Focusing solely on this opportunity for vendors however misses some of the key improvements to care that such tools can also offer.

One such opportunity is the provision of virtual acquisition support; this is one aspect of Philips’ Radiology Operations Command Center and the central focus of Siemens Healthineers’ offering,  Virtual Cockpit. These solutions enable a senior physician or radiographer who isn’t in the same hospital as a patient or the modality, to guide the imaging procedure remotely. There are numerous situations under which such capability could be valuable. The provision of out of hours care, for example. If a patient requires complex emergency imaging in the middle of night, medical imaging could be conducted with junior staff on-site under the supervision of a senior specialist from another site, enabling scans to be taken more quickly than would have otherwise been possible. Similarly, remote acquisition support is also valuable for hospitals, especially in emerging markets, which are struggling as a result of the shortage of medical imaging staff. Enabling experienced staff to guide medical imaging procedures at other sites, even when there is a lack of senior personnel at those sites can help alleviate this pressure. Some discussions with these vendors have also pointed to taking this technology one-step further, with central “hubs” of vendor-managed experienced technicians providing imaging acquisition support.

Joined-Up Thinking

While such capability is beneficial to providers, it will also help vendors make more hardware sales. After all, in some emerging markets, vendors’ opportunities to increase hardware sales, particularly of advanced modalities, are limited thanks to the shortage of professionals that can use them. Virtual acquisition support somewhat mitigates this issue, giving providers the ability to usefully purchase new systems. As such, virtual acquisition tools will invigorate hardware sales in emerging markets.

Beyond this effect, however, hospitals’ adoption of such tools will also have more nuanced impacts. The tools will, as detailed in part one of this series, continue to establish a vendor as a service provider rather than merely being a technology vendor. The changes in these relationships, along with the possibilities offered by the adoption of command centre solutions will lead to developments in the make-up of contracts that vendors and providers enter into.

Chief among these changes will be a gradual uptake of risk-sharing (or benefit or upside-sharing for those particularly PR-conscious vendors) contracts. The detailed analytics of a hospital’s imaging department made possible by the adoption of command centre solutions means that key performance metrics can be better assessed, and imaging departments’ performances can be better quantified. This will enable risk-sharing contracts, under which providers can contractually guarantee the advantages vendors promise.

Learning to Share

The transition to these contracts will not be immediate, with both practical and cultural issues to be solved. Vendors, for instance, will need to be sure that the benefits or challenges a provider is experiencing are because of their intervention. This will be made easier as vendors supply ever-greater portions of a provider’s medical imaging capability. One vendor, after all, would not wish to be penalised because of reliability or other performance related issues of modalities purchased from a competitor. Such nuances will require a degree of consultation and negotiation to be satisfactorily addressed, but over time, as command centres are able to better quantify utilisation and efficiency, they will be.

Other issues are less quantifiable. Providers will no doubt pleased at the prospect at paying significantly less for an imaging service which doesn’t live up to expectations. However, convincing those same providers to pay more to vendors from savings made from use of new technology and operational service support, will be less easy. Given these challenges, vendors should not, at least in the near term, consider such deals big revenue making opportunities.

Instead, they will frequently represent a more protectionist impulse, enabling vendors to become further entrenched at providers and in a better position longer term to upsell additional tools and services. Alternatively, a more aggressive use of such an approach, particularly with a vendor neutral command centre solution, would see a vendor looking to displace an incumbent by offering contractual guarantees that it can offer savings. Not only would this help the challenging vendor get a foot in the door at a provider and promote its services and equipment from within, but more significantly it would give it insight into a rival’s operations and performance. Such data would stand it in good stead to displace its competitor the next time the provider is due to renew its imaging deals.

Making Predictions

There are many different forms these efficiency gains and operational opportunities could be implemented, among the most eagerly expected is the use of predictive analytics.

At present command centre solutions are primarily tasked with collecting, collating and presenting data. This allows professionals, both within a department and external consultants offered as part of managed service deals, clear operational oversight of a hospital’s imaging department. In doing so these professionals can assess hardware utilisation and identify opportunities to improve a department’s efficiency.

Over time vendors plan to increasingly utilise command centres to not only quantify past data and present current metrics, but also identify patterns in the data to be able to make predictions about future use. In doing so, such tools could offer providers suggestions to improve the efficiency of their departments. These could relate to hardware, highlighting opportunities for providers to share equipment among departments, ensuring that a system in one department doesn’t sit idle while another system is at capacity elsewhere. Another potential use case is better managing staffing levels, to ensure that the right professionals, with the right skills, are available and active at the right times.

Adoption will be tempered by scepticism that predictive analytics offers the value it promises. However, this will change. Vendors will use historic data to show where their tools could have been advantageous in the past and providers will become more open to trying innovative approaches as staffing shortages become more acute. Additionally, predictive analytics will also no doubt be a recommendation made by consultants that have been embedded as part of professional services agreements.

Making Plans for the Future

Ultimately, many of these capabilities and trends, whether virtual acquisition support, better analytics support or the increasing integration of vendors within providers’ departments, were already burgeoning, however, command centres neatly bring them together. These solutions are therefore unlikely themselves to be a significant commercial driver. However, the dealmaking opportunities and upsell potential they facilitate can be significant as large medical imaging vendors look to their next stages of growth. They represent the opportunity for a rethinking of contracting, the chance to tap into service budgets and a way of increasing hardware sales in stubborn markets. Moreover, the “ripple effect” of these deals on the competition will become more apparent, pressurising imaging modality vendors with no advanced operational analytics or command centre capabilities. When considering the recent bullish market entry of United Imaging and growing traction in Imaging IT of enterprise imaging specialists such as Sectra and Visage, command centres offer a chance for major healthcare tech vendors to fight back.

GE Healthcare, Siemens Healthineers and Philips did not achieve their global leadership positions by resting on their laurels, and as competitors gain ground they have got to once again strike out, differentiating themselves from their challengers. Considered as such, command centres represent a mission statement as much as a technology.

About Signify Premium Insights

This Insight is part of your subscription to Signify Premium Insights – Medical Imaging. This content is only available to individuals with an active account for this paid-for service and is the copyright of Signify Research. Content cannot be shared or distributed to non-subscribers or other third parties without express written consent from Signify Research. To view other recent Premium Insights that are part of the service please click here

Signify Premium Insight: Establishing a Commanding Position

This Insight is part of your subscription to Signify Premium Insights – Medical Imaging. This content is only available to individuals with an active account for this paid-for service and is the copyright of Signify Research. Content cannot be shared or distributed to non-subscribers or other third parties without express written consent from Signify Research. To view other recent Premium Insights that are part of the service please click here.

This Premium Insight is the first in a two-part series assessing the impact and strategy of command centre solutions for the medical imaging sector.

Hospitals are more connected than ever before. Hardware across hospital networks is increasingly being linked by software, while individual IT systems and separate departments are being joined together, helping doctors and other hospital professionals to reap the benefits of improved access to patient information and advanced technology.

However, some vendors are also increasingly offering tools that can help providers maximise the benefits of these more connected software solutions, supporting operational and clinical decision-making. Such tools look to bring together fleet management solutions for imaging modalities and imaging workflow analytics and business intelligence, for example, along with patient information from the EHR, and aim to make the data more useful to hospitals using the systems. This could help hospitals improve their hardware utilisation, reduce no-shows for appointments, and improve efficiency, among other benefits.

The Signify View

There are, however, several different approaches that vendors are taking to these broad command centre solutions. Some vendors, such as Philips, which offers its Radiology Operations Command Center (ROCC) is, as the name suggests, focused on radiology. The tool is designed to help radiology departments operate more efficiently, allowing patients to be seen more quickly, saving costs for the hospital and utilising collected data to improve the departments in the future. This is a similar strategy adopted by Siemens Healthineers, which offers some similar functionality through its Virtual Cockpit and teamplay/Medicalis product offerings.

Other vendors meanwhile are adopting a more enterprise-wide strategy such as GE Healthcare with its own Command Center solution. GE’s tool primarily looks to bridge the gaps in the EHR, layering analytics dashboards and a user-friendly interface in a bid to create a collection of tools that address pinch points in a hospital’s operational workflow, such as bed management or clinical decision support for certain types of patients, for example. GE’s Command Centre does extend into a hospital’s imaging department, but as yet doesn’t offer an integrated deep radiology focus from the Command Centre platform.

Despite these different strategies, with the different sales channels and different implementations, both vendors offerings have the same ultimate goal – improving a hospital’s efficiency, albeit starting with divergent top-down vs bottom-up approaches.

Mundanity to Profundity?

Despite the grander long-term vision, however, the actual utilisation of many offered tools is still in its infancy, with many of those that have been adopted pertaining to administrative or QA tasks. While customer presentations highlight intelligent systems that provide hospital networks with actionable insights to improve the running of their imaging departments, many of the tools that are being utilised by hospitals are more utilitarian.

Tools such as smart scheduling to ensure experienced professionals are available to conduct scans as they are required, auto-protocolling to streamline the process of conducting scans and tools prioritised because of Covid, such as those allowing patients to self check-in for imaging appointments are all proving their worth. While these tools can be valuable to providers, other capabilities offered under the banner of command centres can also tie into the broader strategic directions being taken by vendors.

At the broadest level, vendors are increasingly transitioning from making transactional sales of medical imaging hardware or departmental software to effectively become ongoing service providers for large hospital networks. These command centres, particularly the more imaging departmental offerings from Philips and Siemens Healthineers, contribute to this broader aim. By deploying a command centre solution centrally, a provider should gain visibility over the performance and efficiency of its imaging department. In doing so, a command centre should be able to help identify underutilised pieces of hardware, areas of inefficiency or spare capacity that can be employed. Collaboratively with providers, vendors can also utilise this information to help schedule maintenance and minimise equipment downtime allowing providers to maximise the value of the systems they have purchased.

At Your Service

This fleet management aspect to command centres can become more valuable as the size and sophistication of a provider’s imaging fleet, particularly those across multiple sites using hub and spoke models etc, increases in complexity. It is also a potentially lucrative channel for vendors, for several reasons.

Firstly, and most immediately, the pressures exerted on medical imaging departments by the backlog of procedures that were delayed because of the Covid pandemic, as well as the budgetary challenges that the pandemic created means that operational workflow and departmental efficiency is a significant driver for healthcare investment. If vendors offer providers a solution that can demonstrably improve their efficiency and therefore save them money and time, hospitals could be willing to purchase new tools, upgrade their systems, or even switch to a new vendor, particularly if a renewal is due.

More significantly, and, arguably more lucratively over the longer term, is that vendors can leverage such tools to become increasingly embedded as service providers at hospital networks, allowing them to tap into operational budgets, a pool far larger than, say, a radiology department’s IT budget.  Beyond selling hardware and software to a provider, vendors will be able to use command centres to upsell professional services. For example, a vendor could look to embed consultants, which could utilise the data streams collated by command centres to drive greater utilisation of the platform, improve the providers’ performance and ensure they meet their KPIs. Effectively, vendors could charge providers to save them money.

This has the benefit of both bringing about short-term revenue gains, but also further tying providers into a vendor’s ecosystem and solidifying a vendor’s position at a provider. Furthermore, such are the revenue possibilities of these service-based offerings, vendors may enter these deals with a “loss-leader” strategy, with limited margin in the first few years, with the reassurance that service upsell will more than compensate over the duration of a 7-10+ year partnership with a provider. This is particularly true if a provider enjoys growth of its own, either through acquisition or expansion, with a vendor being able to organically grow as its customers succeed and extend existing contracts to new sites.

Size Matters

While vendors across medical imaging and beyond are focused on improving customer retention and fostering growth through the development of managed service partnerships, at present, only GE Healthcare, Philips and Siemens Healthineers have grasped the nettle. Fujifilm and Canon, particularly after their respective recent acquisitions of Hitachi and Toshiba, do have the scale to offer such packages, but not the same market demand in the vendors’ key markets such as Japan, therefore, they are yet to prioritise command centres and the analytic tools which would facilitate the same professional services and consulting opportunities GE Healthcare, Philips and Siemens Healthineers are hoping to capitalise on.

These Japanese vendors, over the longer term at least, will be able to offer comparable services. Other vendors may struggle in this regard. EHR vendors are well placed to offer broader, network-wide efficiency tools, albeit ones which lack the richness for imaging departments that large international imaging vendors can offer. Smaller specialist imaging IT vendors, whose nimbleness has allowed them to pinch business off large medical imaging vendors over recent years, may be able to offer some workflow or analytics tools comparable to their larger competitors. However, the size of the vendors, as well as the lack of hardware, limits the opportunity to match the service offering from the larger vendors. Other vendors will not let GE Healthcare, Philips and Siemens Healthineers have entirely free rein over such markets, and more focused, specialist vendors will seek to capitalise on the same trends with purpose-built analytics solutions. However, while providers’ full utilisation is low, having so far only embraced a fraction of the solutions being offered by vendors, over the longer term they will be a key weapon in the large vendors’ fights to further consolidate their positions in the market and derive further revenue from those sites.

 

About Signify Premium Insights

This Insight is part of your subscription to Signify Premium Insights – Medical Imaging. This content is only available to individuals with an active account for this paid-for service and is the copyright of Signify Research. Content cannot be shared or distributed to non-subscribers or other third parties without express written consent from Signify Research. To view other recent Premium Insights that are part of the service please click here