The concept of an enterprise imaging strategy was coined over a decade ago, however, it’s only in recent years that the expansion beyond “enterprise radiology” has truly begun. The total market for IT across those nine specialties included in Signify Research’s report reached $6.6 billion in 2022; however, only 20% of market revenue was associated with enterprise deals. When digging deeper into which specialties led the enterprise trend, radiology represented 71% of the total enterprise imaging IT market.
As demonstrated in the graph below, radiology and cardiology are expected to continue dominating the market opportunities for enterprise imaging, representing 79% of enterprise revenue in 2027. Pathology, oncology, and ultrasound IT are the next largest enterprise imaging markets, forecast to represent 18% of the enterprise market opportunity in 2027.
This graph represents the global market revenue from each of these specialties associated with enterprise imaging deals, as opposed to standalone deals. (f) denotes forecast data. This data is taken from Signify Research's Market Opportunities of Enterprise Imaging – 2023 report, published October 2023.
Recent research with industry stakeholders has centered on the need to consolidate data and make imaging IT systems more interoperable, and it has emphasized the importance of enterprise collaboration to drive better patient care. The question for the market then becomes how providers and vendors alike can move beyond radiology and achieve the ambition of enterprise imaging. And importantly, for imaging IT vendors' investment, evaluating what is the true market opportunity.
VNA resurgence
To take advantage of the momentum surrounding enterprise imaging, most radiology IT vendors are evaluating strategies to leverage existing installed bases to expand into larger, multi-specialty deals. In many instances, that has been a successful strategy, so far. As a result of radiology deals transitioning from standalone to enterprise bundling, stakeholders have evolved. Decisions are increasingly led by C-Suite executives, with the overall influence of the radiology department slowly eroding, limiting some radiology IT vendors from taking advantage of legacy brand recognition.
The success a vendor holds in radiology will however only get them so far; radiology IT vendors will need to evolve along with the market, striving toward interoperable and optimized platforms for technologies such as cloud and AI. In addition, vendors will need to prove capability in managing imaging beyond radiology and DICOM critical. Expansion into other specialties can be complex, with important considerations on data standards and formats (DICOM, video formats, JPEG, plus other clinical formats that are non-DICOM). In addition to image formats, there are also considerations on the management of encounter-based workflows versus order-based workflows. Thus, expansion beyond radiology will be inevitably tied to the diversification of the core enterprise imaging platform, often considered the vendor-neutral archive (VNA) or equivalent products such as enterprise content management.
Building on the central repository of imaging data offered by the VNA, vendors can begin to differentiate further by leveraging the data, alongside EMR and other sources, to produce actionable insights and analytics, and improve productivity not only in radiology but also across all imaging departments and the overall enterprise. Command center-type products are not new in the market, with products available from vendors such as Philips, Siemens Healthineers, and GE HealthCare. However, at this time, there is no enterprise imaging use case – with current products aligned to radiology or enterprise operations as opposed to a broader imaging focus.
Best of breed?
As specialty markets converge and the opportunities for IT intertwine, what does this mean for the best-of-breed (BoB) vendors already occupying the market?
In most instances, larger radiology IT vendors will be seeking a partner, to leverage the BoB brand recognition, specialist tools, and overall expertise in the individual market, whether that’s pathology, oncology, or dermatology. Therefore, for BoB vendors, the priority short-term will be finding the right partner(s) to integrate and target larger enterprise imaging (EI) deals. Geographical representation and market share, customer segment, the overall portfolio and ability to integrate, and broader strategic alignment on cloud and AI will all be important for BoB vendors to evaluate when assessing partners to ensure the “right fit.” This selection will be important, as this creates an opportunity for BoB vendors mid- to long-term.
As enterprise imaging momentum grows outside of the core markets of North America and Western Europe, BoB vendors have an opportunity to leverage a radiology IT vendor's market presence to expand into new geographies. However, additional investment will be required, with the BoB assessing regulatory requirements, any implication or challenges on reimbursement, and customer requirements in new markets, whether that’s a priority on AI integration, efficiency-based tools, or public cloud deployments.
Role for vendors
Although interest is high across North America and Western Europe around enterprise imaging strategy, converting deals can be a challenge. As noted in the graph above, opportunities over the forecast period are expected to be heavily weighted towards radiology and cardiology. Broader expansion is often set back due to market education; what is the best way to adopt an enterprise imaging strategy? What is the value and use case of having smaller specialties such as point-of-care ultrasound (POCUS), dermatology, or ophthalmology integrated into an EI strategy? As well as overcoming the inherent departmental and siloed budgets that make a large EI deployment challenging to fund.
The journey to enterprise imaging will be unique to each healthcare provider, based on specific pain points, contract renewals, and vendor incumbents for example. However, vendors have an opportunity to drive the market forward. Ongoing industry discussions help, but there remains limited visibility on real-world use cases to allow providers to learn from one another, or a framework on best practices to improve the management and roll-out of an enterprise strategy. This is where technology vendors should focus.
Investing in the Future
Amy Thompson of Signify Research.
Undoubtedly, opportunities for enterprise imaging are increasing, with many radiology IT deals evolving to include reference to multiple specialties. Although providers may not be ready for a full enterprise imaging deployment today, providers are seeking a long-term partner that can offer the EI capability when the institution is ready, hence the importance for vendors to invest in platform capability and partnerships now, ready for the future.
However, who will be in the best position to take advantage? The success of an IT vendor will depend on three critical factors: an adaptive sales team, leveraging relationships across the enterprise; class-leading interoperability interfacing across all leading diagnostic verticals; and the ability to clearly demonstrate the economic, diagnostic, and clinical outcomes and tangible benefits to each care pathway.
Market Opportunities for Enterprise Imaging - 2023 assesses the market opportunity for enterprise imaging. Detailed analysis and quantitative summary of EI adoption, evaluating priorities for different ‘ologies and timelines for integration, its impact on product development, combined with our strategic assessment on the role EI will play in imaging IT procurement.
Amy Thompson is research manager for healthcare IT at Signify Research, an independent supplier of market intelligence and consultancy to the global healthcare technology industry. Signify's major coverage areas are healthcare IT, medical imaging, and digital health.
The comments and observations expressed do not necessarily reflect the opinions of Auntminnie.com or AuntMinnieEurope.com, nor should they be construed as an endorsement or admonishment of any particular vendor, analyst, industry consultant, or consulting group.
