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U.S. Medical Imaging IT Middleware

  • May 2013
  • -
  • Frost & Sullivan
  • -
  • 85 pages

A Study of Customer Perceptions and Purchase Intentions in Hospitals

This is a repackaging of this research deliverable. During the fourth quarter of 2009, Frost & Sullivan conducted a Customer Research project titled “Medical Imaging IT Middleware: A Study of Customer Perceptions and Purchase Intentions in the U.S. Hospital Market.” The study aimed to provide the vendors developing, selling, and implementing medical imaging IT middleware solutions with a sound basis to design and execute their growth strategies. Frost & Sullivan targeted 160 U.S. department heads in radiology and cardiology, staff radiologists, clinicians, and hospital information systems administrators. This study utilized Frost & Sullivan’s Web-based survey capability.

Research Objectives

During the fourth quarter of 2009, Frost & Sullivan conducted a customer research project titled “Medical Imaging IT Middleware: A Study of Customer Perceptions and Purchase Intentions in the U.S. Hospital Market.” The study aimed to provide the vendors developing, selling, and implementing medical imaging IT middleware solutions with a sound basis to design and execute their growth strategies. Specifically, the survey was designed to allow them to:
• Identify the perceptions and attitudes of the various stakeholders and decision makers in department and enterprise imaging informatics.
• Determine purchasing patterns and near-term market opportunities.
• Identify current and potential drivers of satisfaction or dissatisfaction as well as the key drivers of adoption and non-adoption of imaging IT infrastructure hardware, middleware, and services.
• Determine the relative importance of product and vendor attributes in the selection process and highlight key areas for competitive differentiation.
• Determine current and future trends in IT strategy workflow and ascertain customer expectations from imaging IT systems.

Industry Background

• Driven by the digitization of film-based, analog medical images, the use of information technology (IT) in the radiology imaging environment, which started in the 1980s, has increased gradually to become ubiquitous, as it is today.
• The first and second generations of IT systems deployed throughout the 1990s and 2000s consisted of primarily single-department radiology information systems (RIS) and picture archiving and communication systems (PACS) often described as monolithic.
• During the last decade, IT platforms underlying RIS and PACS systems have grown wider and more complex, performing the networking and storage function more and more independently of front-end clinical applications.
• Increasing customer requirements from their imaging IT systems’ capabilities have led to the emergence of a more elaborate “IT middleware” layer between the IT infrastructure’s back-end hardware and front-end software components.
• This evolution of the imaging IT infrastructure has created dynamic growth opportunities in medical imaging IT middleware, with such solutions as vendor neutral archives (VNA) and those supporting multi-site, multi-specialty, and multi-vendor IT ecosystems.
• As such, the vendors investing in emerging opportunities include the traditional IT hardware manufacturers and integrators, the vendors of medical imaging applications, and independent and specialized IT middleware vendors.

Scope

• The target respondent base for the online customer survey consisted of high-level decision makers and experienced end users of medical imaging IT middleware systems used at radiology and cardiology imaging sites in the United States, all of which use PACS.
• The targeted facility types include inpatient facilities of all sizes and affiliations, including community-based and academic hospitals that are stand-alone as part of a multi-hospital network of any size.
• By design, the respondent sample that was surveyed emphasizes hospitals of higher bed counts and higher diagnostic imaging procedure volumes, while preserving statistical significance of the smaller sub-segments such as smaller-size and lower-volume hospitals.
• Medical imaging IT middleware is the key element of the study scope. For the purpose of this study, it is defined to survey respondents as software that helps manage the IT infrastructure and optimize its utilization.
• It is further described as forming a layer between IT hardware (server and storage hardware and the network infrastructure), and front-end application software (such as RIS and PACS), and as performing various functions including but not limited to managing image data and optimizing movement across a tiered storage archive’s online, near-line and offline components.

Methods

Sample
Frost & Sullivan targeted X U.S. department heads in radiology and cardiology, staff radiologists, clinicians, and hospital information systems administrators.

Data Collection Methods
This study utilized Frost & Sullivan’s Web-based survey capability. A structured questionnaire with the appropriate metrics was set up in Web format. Appropriate screening questions and quota controls were set to ensure that only qualified respondents participate in the survey. Data was collected in October 2009.

Reporting Notes
Due to rounding errors, percentages in charts and tables may not sum to X.

Executive Summary

• Study results show that the that the most popular and most sought-after functions of medical imaging IT middleware in the current market involve components that:
- Enable remote access to the systems in place, e.g. Web-enabling the incumbent PACS.
- Allow interconnecting disparate PACS systems, e.g. in multi-site and multi-vendor environments
- Allow the managing of images across distributed geographies, the most common in the current market, to be installed at X to X percent of surveyed facilities.
• A deeper interrogation of data uncovers various opportunities. One is the fact that the larger multi-site networks tend to have older PACS technology in place and are most actively looking to invest in medical imaging IT middleware to solve current challenges.
• Based on the economic vendor and product-related attributes most important to customers, the market appears to be oriented toward increasing productivity; the ability of IT middleware to boost productivity and efficiency is well recognized.
• The ability to support a higher procedure volume, driving cost reductions in data storage and leveraging former PACS/IT investments, is also considered an important to the decision to purchase new medical imaging IT middleware.
• There is a notable convergence in the perception of and expectations from imaging IT middleware across providers in various hospital settings. However, some middleware attributes resonate more in specific segments than in others.
• Segment analysis showed that multi-site networks with two to four sites are the customer sub-segment most inclined toward the software-as-a-service model for PACS.
• Major PACS vendors are also the medical imaging IT middleware vendors that have the highest brand awareness in the marketplace. Independent vendors, for their part, suffer from a severe lack of awareness in the market.
• Factor analysis of the survey data allowed Frost & Sullivan to identify distinct profiles of customers for medical imaging IT middleware. One such analysis of adoption patterns helped identify three customer types:
- Data Intelligence Adopters are those already doing advanced mining of both operational performance and clinical data. They favor systems interoperability as the channel to being able to tap into the different HIT systems for the relevant information and measures.
- Distributed Enterprise Adopters include facilities that have implemented medical imaging ÏT middleware primarily as a means to aggregate or federate multiple PACS or RIS systems across multiple sites in order to achieve capabilities such as study sharing with other hospital sites.
- Imaging Virtualization Adopters consist of facilities that have implemented medical imaging IT middleware primarily to automate the disaster recovery process. These customers have also likely implemented cloud storage and started to develop a service-oriented architecture (SOA).

Table Of Contents

U.S. Medical Imaging IT Middleware
Table Of Contents

1. Research Objectives and Methods
2. Executive Summary and Implications
3. Profile of Respondents
4. Background: Multi-Site Configuration and PACS/HIT Adoption
5. Procedure and Data Volumes
6. Multi-PACS Configuration and PACS Replacements
7. Current State of Medical Imaging IT Middleware Adoption
8. Purchase Plans and Upgrade Timeline
9. Imaging IT Middleware Budgeting
10. Brand Awareness and Brand Perception
11. Directions in Choosing a Medical Imaging IT Middleware Vendor
12. Drivers of Adoption—Organizational Goals and Perceived Benefits
13. Purchase Decisions—Originating and Influencing Stakeholders
14. Economic, Vendor, and Product Attributes in Purchase Decisions—Market Segmentation
15. The Frost and Sullivan Story

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