PACS at HIMSS: Changes in attitudes, changes in latitudes

By Michael J. Cannavo, AuntMinnie.com contributing writer

February 22, 2019 -- I would venture a bet that no one in radiology woke up and said, "Let's go to HIMSS to look at PACS" -- and rightfully so.

Compared with RSNA, the annual HIMSS meeting has twice the number of vendors competing for your attention (more than 1,300 vendors versus just over 700), half the amount of time to see everything (2.5 days versus five), and at least 75% fewer PACS vendors (a couple dozen, at best, covering all areas of enterprise imaging systems, which include PACS).

Michael J. Cannavo
Michael J. Cannavo.

Traffic around Orlando's Orange County Convention Center put downtown Los Angeles to shame; it took me 1.5 hours to travel four miles on Wednesday. With a few exceptions, seeing PACS at HIMSS 2019 was relegated to one to two workstations (at best) in each booth around the periphery of the exhibit hall, with more prominent space given to other healthcare IT applications.

So why go to HIMSS to look at PACS? Well, you really don't, but since you're already there, you might as well take a peek.

In years past, HIMSS attendees needed to visit with PACS vendors to ensure their facility could support the hardware and software being provided by the vendor. In today's world, where many of the sales are software-only and hardware is often virtual (or, if physical, is purchased by the hospital and supported by IT), the roles of both the IT department and the chief information officer (CIO) have changed.

These individuals need to understand the global picture of how PACS fits into the electronic health record (EHR). This requires vendors to show interoperability with the EHR (typically from Epic or Cerner) beyond basic HL7 interfaces. They also need to know how third-party applications such as artificial intelligence (AI) can be integrated into PACS.

The PACS vendors that had large areas of their booths dedicated to imaging did this well. Others, especially the major vendors, often struggled with discussing their PACS, and they didn't describe how it will interface/integrate with the EHR. In a show that was supposed to highlight interoperability, no vendor I saw came out and said in their posters: "Proven interoperability with ..." You had to come inside and get the pitch -- if there was a pitch to be made, and you could find someone there who actually knew the pitch.

That's the challenge of reusing booths for various trade shows. Conference attendees and their needs are often quite different from trade show to trade show, but the messaging that brings people to the booth almost always remains the same. What's great for RSNA could be lousy for HIMSS.

There was a smattering of vendor-neutral archive (VNA) vendors at HIMSS, as well as a small number of AI vendors. The latter was a surprise given the huge promotion that AI has received recently, and the HIMSS resource guide listed more than 125 vendors in the AI category. Still, the few dedicated AI vendors that were at HIMSS 2019 received good foot traffic, and deservedly so.

Interest in VNAs seems to have peaked a few years back, although some interest is still there. Technical issues such as cost and time related to data migration have significantly affected the market growth of VNAs.

Interestingly, but not surprising, cybersecurity seemed to have the biggest play at HIMSS 2019, with the show's Cybersecurity Command Center packed every day. The Interoperability Showcase was also busy, but most people wanted to see actual interoperability as it relates to their specific PACS/enterprise imaging system (EIS) vendor, not global discussions about the use of Fast Healthcare Interoperability Resources (FHIR) as it relates to interoperability.

I didn't have the opportunity to go to any of the educational presentations, longer specialty presentations, or networking events, but I wish I had, as many seemed very good. There simply wasn't time. Of special interest was the HIMSS Digital Imaging Adoption Model - Enterprise Imaging (DIAM-EI) that was developed in conjunction with the Society for Imaging Informatics in Medicine (SIIM) and others.

Nearly every booth at HIMSS 2019 had some trinket as a giveaway, although, seriously, how many pens, cellphone card holders, phone carriers, and hand sanitizers does one really need? The free food and booze during happy hour were very nice, even though I couldn't imbibe (I had to drive home); it reminded me of the European Congress of Radiology in years past, and it brought many people to what would have otherwise been vacant booths. Sadly, the RSNA is too stuffy and stodgy to consider something like this.

By the end of just two days, I was already singing "my head hurts, my feet stink, and I don't love Jesus" in my best Buffet-like voice (even though I do love the big man upstairs), not just because that was how I felt but also because it would have been politically incorrect to sing other Buffet songs, such as "Why don't we get drunk and ..." I'm sure a few attendees were singing "Margaritaville," with the booze flowing as freely as it did. The weather never really cooperated to give us liquid sunshine, but most of the people from higher latitudes said they felt good about not having to shovel snow, at least.

With only two days on the exhibit floor, you really don't have time to get into much detail, but I saw enough at HIMSS 2019 to allow me to hand out the 2019 PACSman Awards: HIMSS edition. Here they are, in no particular order.

The Toto I Don't Think We're in Vegas Anymore Award

To the organization that sent out a press release highlighting HIMSS 2018 -- when we were attending HIMSS 2019 in Orlando.

The Safe Sox Award

To the dozen or so companies that gave away socks. One tied it up nicely with a "we'll knock your socks off" comment, but the rest? Who knows.

Display of available socks
All images courtesy of Michael J. Cannavo.

The Stephen King Award

To the company that had these two babies holding pens that looked like hypodermic needles at first glance.

Two baby dolls holding pens

The Who Has Been Eavesdropping on My Dates Award

To the company that had this dialogue posted in its booth that I swear came from one of my more recent dating encounters.

Display showing chatbot dialogue

The I Don't Want to Know Award

To the company that handed out cowbells and shot glasses together. Any information here is TMI.

Table with rows of cowbells and shot glasses

The Reporting Every Dollar We Earn Award

To the hotel adjacent to the convention center that charged $17 per car -- cash only -- to park in its parking garage. No tickets, no receipts, just a smile from the attendee.

The Truth in Advertising Award

To the company that gave away really nice black T-shirts that said "insane" on the front and had just a small company logo on the back. I'm sure if they were more prominently positioned every CIO and IT person would want one.

Woman and man wearing T-shirts showing the word insane on the front

The Diet? We Don't Need No Stinkin' Diet! Award

To the company that had the most delicious fresh-made, hot-from-the-oven cookies I have ever tasted. They were made onsite by employees in company-owned ovens, and you could have as many as you wanted. The great thing for them is I actually stayed long enough to see what the company does (revenue cycle management), so it worked.

Woman standing in front of counter full of cookies

The Oh to Be a Kid Again Award

To the company whose "What's a Booger?" mouse pad replaced my boring worn out black one. It also had stickers that said "Why do I burp?" and "Why do feet stink?" -- among others. The company even offered me my own personal green stuffed booger, but because I have been sick all week and had been dealing with boogers of every size, shape, and color already, I politely declined.

Mouse pad showing a baby picking its nose with text reading, What

The Witness Protection Act Award

To the company that offered software and consulting services to assess and optimize electronic medical record (EMR) system performance to hospitals using a major IT vendor's products, yet had to disavow any use of the name of the EMR company it is known industry-wide as an expert in.

The Suppose They Gave a War and Nobody Came Award

To the no-show vendors whose absence was highly noticeable. The least they could have done is put a table and chairs out there so we didn't have to eat our cookies on the run.

View of an empty vendor space at the conference

The Have We Finally Met Our Match? Award

To the company that had attendees play the "Match Game" and try and get the fastest score by matching up products and services. Gene Rayburn, we miss you! Good thing this wasn't in another vendor's booth, or I'd have the highest score ever from trying to match PACS with EIS and being told by the vendor that PACS doesn't exist anymore.

Woman looking at Match Game display with timer

The Fancy Words Award

To the company that promoted "contextually aware experiences," but no one in the booth knew what it meant.

Sign with text for contextually aware experiences

The No Bull Award

To the company that gave us all the bull we ever wanted but could deflate it at a moment's notice. Now that's my kind of bull.

Large, inflatable bull

The Bruce the Shark Award

To the company whose trademark is to give away really nice stuffed fish. I kept thinking, "I am a nice shark, not a mindless eating machine. If I am to change this image, I must first change myself. Fish are friends, not food." And then I went to FishBones with my counterpart Erik Ridley for a nice grilled mahi dinner.

Pile of plush, stuffed fish

The Tequila Makes Your Clothes Fall Off Award

Finally, to the company that gave you a chance to win a huge bottle of George Clooney's very own Casamigos tequila -- and even if you didn't get the big bottle, you got a smaller 50-mL bottle. If that's not a win-win, I don't know what is. And God knows after a day on the floor of HIMSS 2019, 50 mL is a good start to taking the edge off a very long day.

Two women standing with a bottle of tequila

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 developing market-focused messaging as well as sales training programs. He can be reached at pacsman@ix.netcom.com 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 AuntMinnie.com.


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