The PACSman Pontificates: Dog tired after HIMSS 2024

Michael J. Cannavo.Michael J. Cannavo.

Lying in bed the night after my visit to the Healthcare Information and Management Systems Society (HIMSS) 2024 meeting in Orlando with my legs moving like Elvis in concert and my kidneys on overdrive from all the water I drank trying to stay hydrated, I heard the music from the movie Chariots of Fire running through my head.

I looked it up this morning and understood why. “This is the story of two men who run ... not to run ... but to prove something to the world. They will sacrifice anything to achieve their goals.” That pretty much summarizes how I felt after a full day walking the exhibit hall trying to assess the PACS and AI market at what is by all accounts an IT show.

AI was the talk of the show with seemingly every other vendor promoting AI except those within the medical imaging community. It seems that AI, or at least what is promoted as AI, is being used for all sorts of data. The most popular application was sorting through the vast amounts of patient data to pull out relevant pieces of information for specific patient encounters and population health traits.

This automated data analysis is designed to target patients for additional care or resources, to streamline diagnosis, workflow, or aid in data mining or identifying patterns in data. This is very time-consuming and difficult for humans to do accurately or easily and a perfect application of AI. All over the show floor, other AI offerings were seen in population health, revenue cycle management, nurse management, patient monitoring, health tracking, data analytics, patient wellness, and preventative applications -- as well as others I had never considered.

A much better show

Overall the show was much better in many respects than in previous years with a solid attendance of over 30,000 attendees and nearly 1,000 vendors. This is in large part due to the new partnership between HIMSS and show management company Informa.

That said, each year it seems that fewer and fewer PACS vendors choose to display at HIMSS. Why? Trade shows aren’t cheap and vendors have to pick and choose the meetings where they get the greatest exposure to those who make the buying decisions and don’t merely just influence or collect data. This is especially relevant since most vendor marketing budgets have been cut back.

Attendees also have to pick and choose where they can get the best bang for the buck.  As part of their RSNA membership, radiologists get to attend the annual meeting for free. RSNA is also not just a technical show where they can evaluate the latest and greatest imaging modalities and systems like PACS, AI, and other technologies but a social event for many as well.

In contrast, it can easily cost thousands for an individual to attend HIMSS for a day or two once everything is added up. It’s a good deal for IT people but not nearly as good a deal for radiology.  Most hospitals will pay for IT staff to attend HIMSS or VIVE, another digitally-focused trade show that primarily attracts hospital C-suites, since there are many things the C-suite at the hospital often need to evaluate as well.

Radiology presence

Since radiology support staff and radiologists are only at HIMSS to look at a few dozen radiology vendors at best (out of 1,000 total) it makes attendance much more difficult to justify. The vast majority of those attending HIMSS were IT folks who wanted to look at various clinical systems and better understand radiology systems being presented by their radiology counterparts. Only a few were accompanied by radiology representatives.

While most of the feedback I got from radiology vendors about the show was positive, it’s hard to tell how exhibiting translates to a sale, versus education so that IT will sign off on the vendor decision suggested by radiology. I would also love to have seen more discussion and examples of systems integration, especially with electronic medical records (EMR).

As previously stated there were nearly two dozen or so PACS vendors displaying their wares -- both PACS and vendor-neutral archives (VNAs) combined. Mostly it was the major vendors, one recognizable independent, and just a few medical imaging AI vendors.

If you want to stretch it and include the three major Cloud providers who work in the PACS realm you can add those as well. Frankly, while all had a significant show presence I was thoroughly unimpressed by the lack of knowledge each had relative to the use of the Cloud in PACS applications. That said, the Cloud was pretty much all that was talked about from a systems architecture standpoint; most on-premise systems were relegated to only a system redundancy role.


The acronym PACS seems to be no longer taboo, even though several vendors started to use enterprise imaging system (EIS) in place of the longstanding acronym over the past few years. In this setting, EIS would actually be more appropriate. However, it can be hard to converse with a vendor if it’s not clear what they mean when they use that term. PACS has gone through more than one attempt to change its name from IMAC (Image Management and Archive Communications) on down but a PACS by any other name is still a PACS.

The balance of power seems to have shifted back to radiologists from IT in the decision-making process. This has been a slow evolution over the past few years but the transition is pretty much complete now with radiologists having the final say in which vendor gets selected instead of having the decision forced down their throats like a hot dog by Joey Chestnut at a timed eating exhibition.

This is not to say that IT no longer has a say in the decision-making process especially as it relates to networking, cybersecurity, and other IT areas. Having IT choose the vendor was like my Mom making me dinner and telling me that I had to eat it or go hungry. Radiologists now have the balance of power to make the final decision and IT just needs to sign off on that decision or identify issues for why they can or will not.

Digital pathology is starting to gain a foothold in the imaging world even though the regulations about retaining slides, wax blocks, etc. have yet to change. Just as there is a radiologist shortage there also seems to be a pathologist shortage and digital pathology enables studies to be read quicker. Data can also be more easily shared with the requesting physician as well.

Puppy Park

So what was the most interesting part of HIMSS? It actually had nothing to do with clinical systems, but rather a Puppy Park. Yes, a puppy park. One of the local pet rescues set up a small fenced area, maybe 20’ x 20’, and had it stocked with puppies that people could play with and hopefully adopt.

Booths at HIMSS always provide plenty of bling; almost every booth gave away something from pens to flashing cups to stuffed animals. But what booth provides a better feeling of being recharged by playing with a puppy?

There were lines of people waiting for their turn … can you imagine the look on kids' faces when they got home? “Mom, what did you bring me from the show? A PUPPY!! Wow, you ARE the very bestest mom!!” as your husband looks on incredulously wondering where your mind went in making this unilateral decision.

I just spent the past year enjoying Daisy, our Labrador puppy, and we celebrated her finally sleeping through the night just last week. That’s good because no way was I getting out of bed to let her out after that full day at HIMSS 2024.

Michael J. Cannavo is known industry-wide as the PACSman. After several decades as an independent PACS consultant, he worked as both a strategic accounts manager and solutions architect with two major PACS vendors. He has now made it back safely from the dark side and is sharing his observations.

His healthcare consulting services for end users include PACS optimization services, system upgrade and proposal reviews, contract reviews, and other areas. The PACSman is also working with imaging and IT vendors to develop market-focused messaging as well as sales training programs. He can be reached at [email protected] or by phone at 407-359-0191.

The comments and observations expressed are those of the author and do not necessarily reflect the opinions of

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