Based on the Meaningful Use data published by the Centers for Medicare and Medicaid Sevices (CMS), it’s two smaller companies that lead the market for radiology EHRs: MedInformatix (14.9%), which received more than a third of its attestations from radiology, and Merge Healthcare (14.5%), which serves exclusively radiology and orthopedics. EpicCare is third with 10.2%, The next highest ranking company has less than a third as much business as either of these two, and the numbers only go down from there.
|Epic Systems Corporation||234||10.2%|
|Partners Healthcare System||140||6.1%|
|Advanced Data Systems Corporation||102||4.4%|
|DR Systems, Inc.||99||4.3%|
|Vitera Healthcare Solutions, LLC||68||3.0%|
|UT MD Anderson Cancer Center||56||2.4%|
|Center for Diagnostic Imaging||53||2.3%|
|Alere Wellogic LLC||48||2.1%|
It’s interesting to note that because of the unique nature of radiology as a specialty, many of the popular EHRs are those that focus on imaging. Some of them—like MagView, Center for Diagnostic Imaging, Alere, and DR Systems—work exclusively in the radiology field. Some target radiology and a few other areas--for example, MedInformatix has a strong showing in family medicine, cardiology and internal medicine; Merge Healthcare focuses on radiology and orthopedics; Advanced Data Systems hits internal medicine, cardiology and gastroenterology; and UT MD Anderson Center hits each of the oncology, radiology and pathology specialties you’d expect given their focus.
According to the data, 96.7% of EHR purchases are for complete EHRs. The remainder are for modular EHRs, those that contain some but not all elements of an EHR (e.g., medical imaging). Ninety-eight percent are being used in ambulatory practices.
Interestingly, the leading state for radiology EHRs is New Jersey--it has more than four times as many radiology EHRs than would be expected from its population.
Although we recognize that the CMS data used to furnish this report is not exactly the same as market share, we’ve been using it to compile these reports, since it gives us an advantage in tracking data for the top EHR products available.
Of the 229,132 entries in the original data, 2,865 were used to compile this report. The great majority of these (2,657) came under the Diagnostic Radiology specialty, with 152 from Interventional Radiology and 56 from Nuclear Medicine. Note that because of the way the data is reported to CMS, these 2,865 entries represent only 2,150 medical providers, some of whom are using multiple products. The culled down data is available here.
Radiology Software Overview
Radiology information systems (referred to as “RIS” by most users and vendors) have been around since the 1980s and have been tailored to meet the needs of both small and large organizations. The RIS market has become flooded with vendors since then, resulting in a fragmented market that most buyers find confusing to navigate. We’ve written this guide to give buyers a lay of the land to start their research and comparisons.
Here’s what we’ll cover:
What is a RIS?
Radiology information systems help radiology centers manage clinical and administrative data and automate workflows. At the user level, a RIS helps collect patient demographics and contact information, schedule appointments, track images, manage inventory, and report on results. A RIS provides automation of repetitive tasks for administrative staff and increases efficiency for providers.
Most radiology information systems will offer an HL7 interface to enable integration with picture archiving and communication systems (PACS), electronic medical records systems (EMRs), or hospital information systems (HIS). More advanced systems will offer functionality for dictation support, result delivery via e-fax and email, mobile support, and customizable reporting.
Buyers of radiology software programs will have the choice of implementing a standalone RIS or an integrated RIS and PACS. Due to the complementary offerings of both, it is fairly common for RIS buyers to implement integrated RIS and PACS suites. The decision to implement a standalone RIS or a complete RIS/PACS is dependent on users’ unique needs and environments.
What Type of RIS Buyer Are You?
It is important that buyers assess what type of buyer they are before evaluating vendors. Just about all buyers can fall into one of the following three categories:
- Small radiology centers. These buyers typically work in radiology centers with fewer than 10 providers. They have the most straightforward needs of the three buyer categories.
- Enterprise radiology centers. These buyers work in radiology centers that have at least 10 physicians on staff, although they may be much larger. These buyers will typically require a robust RIS capable of integrating with PACS and HIS.
- Hospitals. These buyers work in radiology departments within hospitals and typically manage a large amount of radiological information and images originating from several locations or users. They are aiming to integrate with HIS and eliminate a lot of the inefficiency associated with managing information on paper.
The RIS Vendor Landscape
While the radiology information systems market is complex and fragmented, buyers can quickly understand where to look by segmenting the industry along the lines of the three buyer categories mentioned above.
|This type of buyer...||Should evaluate these systems|
|Small radiology centers||RISynergy, Medics RIS/PACS, Sage Intergy|
|Enterprise radiology centers||GE, Medics RIS/PACS|
|Hospitals||GE, Siemens, Philips|
Market Trends You Should Understand
There are two important healthcare software trends that are important to understand when evaluating the RIS market:
- Software as a Service (SaaS). The SaaS delivery model has disrupted a number of software markets, including RIS. Many buyers prefer systems that “sit in the cloud” and require low upfront costs, little IT infrastructure, and greater accessibility. Many vendors now offer SaaS solutions and buyers should be ready to evaluate this model with an open mind.
- Integration and interoperability. Buyers should be aware of the widespread push towards integration among disjointed healthcare networks. As providers and government legislators recognize the costs and inefficiencies in the healthcare system due to paper, large and small RIS buyers need to consider whether their vendor supports open standards and integration with EMRs, hospital information systems, and health information exchanges.
Benefits & Potential Issues
When implementing a RIS, buyers should primarily expect to realize the following benefits:
- Efficiency. By eliminating paper folders, hardcopy images, and manual methods of tracking data, radiology centers should expect to increase efficiency when transitioning from a fully manual office to one powered by a RIS.
- Uniformity. RIS are able to enforce best practices for radiology center workflow, including reviewing images, storing information, and sharing data with other organizations. A formal system ensures that all necessary steps will be taken without key tasks being forgotten.
- Automated reporting. Buyers should find that it is much easier to run reports on various criteria, enabling them to determine trends in outcomes and make data-driven decisions.
As with all technology, there are potential risks to consider as well. The first issue on most RIS buyers’ minds is patient privacy, which most companies have addressed with fully HIPAA-compliant systems. The second concern we hear about most often is in regards to ease of use. While most ease of use issues can be addressed with training, buyers will want to perform a thorough evaluation of their selected RIS to make sure the workflow is logical and the layout is intuitive.
Recent Events You Should Know About
As medical practice software changes and new software solutions become readily available, vendors offering radiology-specific applications are becoming more advanced, and more compliant with Meaningful Use initiatives. Ninety percent of radiologists are eligible for Meaningful Use reimbursements if ten-percent of their services are provided outside of emergency or inpatient care. There are many radiology information systems vendors (RIS) that are offering state-of-the-art applications and compliance with changing government standards. EHR systems for radiology offer an abundance of industry-specific tools. The cost of RIS systems vary, ranging from open-source programmers that have created free radiology information systems, all the way to top-of-the-line, integrated suites. Meanwhile, there’s both cloud radiology vendors as well as on-premise options. Some of the trending vendors are:
- MedicsRIS/PACS - MedicsRIS/PACS provides compliance with Digital Imaging and Communications in Medicine (DICOM) medical imaging software and DICOM worklist standards. Addressing the communication difficulties between Health Level-7 (HL7) and DICOM medical imaging software, MedicsRIS/PACS provides full integration between imaging sources for transmission to PACS imaging software.
- medinformatix - medinformatix’s Complete Electronic Health Record (EHR) system is 2011/2012 compliant and certified by an ONC-ATCB in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services. In October 2011, San Diego Cardiac Center implemented medinformatix’s Patient Management (PM) and EMR software, transitioning entirely into a cloud-based system.
That said, there are many solutions that can integrate with PACS, offer third party speech integration, and deployable HL7 interfaces. To help compare RIS systems, we offer a thorough database of both on-premise and cloud-based radiology reviews.