Competitive Dynamics in the
North American VNA Market
Theo Ahadome
Senior Analyst
InMedica
Theo.ahadome@ihs.com
Types of VNA
InMedica has identified the following VNA architectures
•
Level 1.0 – Departmental Archive (DICOM): This refers to a VNA used in a single imaging
department, usually radiology. Such architecture must still meet all the minimum components of a
VNA discussed in Chapter 2. However, its sole purpose is to provide lifecycle management and
disaster recovery for one department. It does not need to share images with multiple PACS.
•
Level 2.0 – Multi-department DICOM (Enterprise): This refers to a VNA used to manage and
share data between multiple PACS in different departments within the same hospital, such as
between radiology and cardiology. It primarily handles DICOM images from these departments. It
can also handle non-DICOM images by either converting it to DICOM or by keeping it in its native
format.
•
Level 2.1 – Multi-Site DICOM (Enterprise): This refers to a VNA used to manage and share
images between multiple PACS at different hospital locations. This may be between radiology
departments, or involve other departmental PACS. The architecture of this system must be
somewhat different from Level 2, to handle requirements from different geographic locations.
•
Level 3.0 – Multi-department XDS (Enterprise): This refers to a VNA used to manage and share
images and non-image across departments using XDS or similar protocols.
•
Level 3.1 – Multi-site XDS (Enterprise): This is similar to Level 3.0, but is configured to integrate
departments across different hospital locations within a network.
© 2012 IHS. No portion of this presentation may be reproduced, reused, or otherwise distributed in any form without prior written consent.
Types of VNA
100.0%
Multi‐Site XDS
90.0%
80.0%
Single‐Site XDS
70.0%
Multi‐Site DICOM
60.0%
50.0%
Multi‐Department DICOM
40.0%
30.0%
Single‐Department DICOM
20.0%
10.0%
0.0%
2011
2012
2013
2014
2015
2016
North American Market - Types of VNA – Relative Proportions of Study Volumes
•
•
•
Departmental archives accounted for only 18.0% of study volumes in 2011; this will decrease
to less than 10% by 2016.
Enterprise VNA accounted for 82%; of which XDS is 11%.
By 2016 XDS-based Enterprise VNA to account for 30% of VNA studies.
© 2012 IHS. No portion of this presentation may be reproduced, reused, or otherwise distributed in any form without prior written consent.
PACS Vendors
•
As the VNA market has developed over the decade, PACS suppliers have responded with
different strategies. Initially, most vendors opted to address the need for cross-departmental
image access by developing enterprise PACS products. These essentially allowed imaging
departments outside of radiology to share the radiology PACS product. However, without being
specifically designed for other departments, some of these products did not meet the different
viewing and workflow needs of these departments. Subsequently, department-specific products
were developed for specialties including cardiology, orthopedics and mammography.
•
These solved the imaging requirements of these departments. However, it also meant that images
were being increasingly compartmentalized in disparate systems, thus increasing storage
requirements and limiting the ability to share images across departments. The limitations of PACS
with regards to managing the lifecycle of an image, providing access to disparate PACS from
other vendors, have led some PACS vendors to develop VNA products.
•
A challenge for PACS suppliers in the VNA market is to prove the ability to deliver a nonproprietary, standards-based approach to archiving that gives healthcare providers control of their
data without being locked in to their PACS.
•
Some PACS vendors can deploy their traditional PACS as a full enterprise archive which provides
storage consolidation, lifecycle management and cross-departmental image sharing. These
systems are not considered a VNA product due to the lack of a separate DICOM conformance
statement and regulatory approval which is separate from the PACS product, and a general
inability to interface with other PACS.
© 2012 IHS. No portion of this presentation may be reproduced, reused, or otherwise distributed in any form without prior written consent.
PACS Vendors
•
Agfa Healthcare, Carestream Health, GE Healthcare and Merge Healthcare have all developed
VNA products, either in-house, or through acquisitions. These suppliers were earlier-to-market
with their VNA products, driving market leadership. Of these, GE Healthcare has the largest share
of departmental archives in North America. While GE has a leadership in departmental archives,
other PACS suppliers have established their leadership in cross-departmental, multi-PACS
enterprise archives.
•
PACS suppliers without a VNA product in 2011, as defined by InMedica, include Philips
Healthcare, Siemens Healthcare, Fujifilm and McKesson. Fujifilm and Philips Healthcare partner
with VNA suppliers including Acuo Technologies and Siemens Healthcare has partnered with Dell
to supply VNA.
•
It should be noted that some enterprise PACS may meet , albeit in a restricted manner, some of
the challenges of image sharing and workflow efficiencies that drive VNA adoption. As such, the
decision to deploy a VNA or other enterprise architecture should reflect the challenges that a
healthcare provider faces and the extent to which a vendor’s enterprise product (VNA or
otherwise) meets those challenges.
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PACS to VNA
PACS Installed Base
Philips
GE
Agfa
McKesson
Fujifilm
Merge
Siemens
Carestream
Departmental VNA Installed Base
Philips
Agfa Healthcare
Merge Healthcare
Siemens
GE
McKesson
Carestream
Note - Size of bubble represents PACS Installed Base in North America.
© 2012 IHS. No portion of this presentation may be reproduced, reused, or otherwise distributed in any form without prior written consent.
Fujifilm
Departmental VNA Installed Base
Departmental to Enterprise VNA
GE
Agfa
Carestream
Merge
Dell
Teramedica
Acuo
Enterprise VNA Installed Base
Agfa Healthcare
Merge Healthcare
Carestream
Dell
Acuo
Teramedica
Dejarnette
Note - Size of bubble represents Enterprise VNA Installed Base in North America.
© 2012 IHS. No portion of this presentation may be reproduced, reused, or otherwise distributed in any form without prior written consent.
GE
Independent Vendors
•
Independent software vendors (ISV) are who those that have a proprietary VNA product, but not a
proprietary PACS. These suppliers have emerged from outside of the PACS market to meet the
some of the challenges created by departmentalized data silos.
•
The leading ISV’s in the VNA market are Acuo Technologies, Dejarnette Research Systems and
Teramedica. These suppliers are positioned to provide a product independent of PACS for
healthcare providers whose major challenge is to clearly separate PACS application and image
storage.
•
As the VNA market develops towards full enterprise integration of image and non-image data,
independent VNA vendors are projected to benefit the most. VNA from many PACS vendors have
a strong bias towards DICOM data; even non-DICOM data is converted to DICOM for storage. A
DICOM-biased VNA still meets the needs of healthcare providers.
•
Over 65.2% of VNA revenues in worldwide 2011 were from managing DICOM images in multiple
departments or at multiple hospital sites, reflecting that current demand is driven by the need to
consolidate images and reduce image migration costs. However, as VNA penetration increases, so
too will demand for larger integration of non-DICOM and non-image data. By 2016, XDS-based
VNA is projected to account for 30.6% of revenues worldwide; VNA suppliers, who currently
provide full XDS document registry and XDS repository features in their VNA, are well positioned
to benefit from this shift in demand.
© 2012 IHS. No portion of this presentation may be reproduced, reused, or otherwise distributed in any form without prior written consent.
Independent Vendors
•
Traditional storage suppliers are also important in the VNA market. These companies may provide
the servers and host data from VNA. It is estimated that 11,302 terabytes of new studies were
stored by VNA in 2011; this is projected to increase to 114,919 terabytes in 2016. In addition,
hybrid and hosted cloud models, are projected to account for 38.5% of VNA study volumes in
2016.
•
Storage and infrastructure companies currently partner with VNA vendors to host data managed by
the VNA. For example, AT &T and EMC partner with Acuo Technologies; Netapp partners with Iron
Mountain; and Iron Mountain partners with Dejarnette. Such partnerships may be on a per project
basis, or more commonly, the infrastructure provider may market a solution which incorporates the
partner VNA product. Dell Healthcare, maintains similar partner relationships. However, Dell also
provides a proprietary VNA.
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Departmental VNA Installed Base
Future Direction
GE
Agfa
Carestream
Merge
Dell
Teramedica
Acuo
Enterprise VNA Installed Base
Agfa Healthcare
Merge Healthcare
Carestream
Dell
Acuo
Teramedica
Dejarnette
GE
Note - Size of bubble represents Enterprise VNA Installed Base in North America. Arrow indicates projected direction of growth in
installed base
© 2012 IHS. No portion of this presentation may be reproduced, reused, or otherwise distributed in any form without prior written consent.
Future Direction
PACS Vendors
As demand for VNA grows and healthcare providers seek better control of their data, PACS suppliers
are well positioned to increase their departmental VNA installed base by providing VNA to their
radiology PACS customers. The bigger challenge for them is to meet the needs of healthcare providers
across departments.
•
•
•
•
Agfa Healthcare’s IMPAX Data Centre VNA provides hospital wide access to images and is
combined with its Imaging Clinical Information System, to integrate images into a cross-enterprise
workflow to support access to images from the Electronic Health Record (EHR). Agfa is hence
expected to increase its presence both in terms of departmental archives and enterprise VNA
installations.
GE Healthcare has the largest departmental VNA installed base in North America through
Centricity Enterprise Archive. It has also recently launched Centricity Clinical Archive to provide a
wider non-departmental approach to an XDS-enabled archiving and workflow environment.
Centricity Clinical Archive is classed by InMedica as a VNA Level 3.1 (highest possible
configuration) and is projected to drive GE’s presence in the Enterprise VNA market.
Merge Healthcare has the largest VNA Enterprise installed base in North America. With the
introduction of Merge Honeycomb Archive as a cloud-based platform to further enhance image
sharing, Merge seeks to solidify its position as a provider of non-proprietary imaging IT platforms.
Carestream Health, with the second largest enterprise VNA installed base in North America, also
focuses heavily on cross-departmental synchorinization of patient data through Vue Connect.
Growth in the VNA installed base is projected from Carestream’s PACS installed base, from a
departmental viewpoint, as well as from non-Carestream PACS customers, to consolidate DICOM
and non-DICOM data.
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Future Direction
Independent Vendors
Independent VNA vendors have a greater presence in enterprise than departmental VNAs as they
focus more on cross-departmental access to images and other forms of data. As VNAs are increasingly
used for this purpose, they are projected to increase their presence further.
•
•
•
•
Acuo Technologies is the leading ISV in North America in terms of VNA installed base, a position
it has achieved as an early entrant in the VNA market with a focus on PACS interoperability, XDS
and zero footprint viewing. It has also successfully partnered with the largest number of third-party
vendors including Philips, EMC and AT&T.
Dell Healthcare, through its acquisition of Insite One, has established its unique position as one of
the only storage providers with a proprietary VNA solution. Dell primarily provides a cloud-based
VNA solution, which combined with its experience in data storage, addresses the demand for
reduced costs and consolidated medical data storage.
Teramedica is also one of the earliest providers of VNA solutions and its Evercore product has
been deployed in departmental and enterprise models. It is, however, the cross-departmental
approach to PACS data access with analytical tools that is projected to continue to drive its
presence in the enteprise VNA market.
Dejarnette, arguably the earliest provider of inter-legacy PACS integration tools, developed
systems to enhance data migration and connectivity of PACS systems. Out of these, the VNA
concept was formed and it has since continued to provide a standards-based approach to data
storage and workflow integration across departments.
© 2012 IHS. No portion of this presentation may be reproduced, reused, or otherwise distributed in any form without prior written consent.
Conclusion
•
For healthcare providers, it is encouraging that VNAs are an increasing priority for PACS vendors;
the availability of ISVs also increases the options available. As the issue swiftly moves from
“whether or not to adopt a VNA” to “which VNA to adopt,” it is up to vendors to prove their ability to
meet the most important VNA adoption requirements: reduced storage costs, reduced migration
costs, enhanced image sharing, synchronized cross-departmental workflow, enhanced business
continuity and enhanced non-image data sharing.
© 2012 IHS. No portion of this presentation may be reproduced, reused, or otherwise distributed in any form without prior written consent.
Contacts
Theo Ahadome
Theo.ahadome@ihs.com Tel: +44 1933 402 255
IHS Media Relations
press@ihs.com Tel: +1 303 305 8021
Alternative Contacts:
Asia Pacific
Yvonne Zhang
yvonne.zhang@ihs.com Tel: +86 21 6720 1823
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About InMedica (www.in-medica.com)
InMedica is the medical technology research division of IMS Research, the leading provider of market research and consultancy to the global
electronics industry. InMedica publish high quality, in-depth market research on key medical markets including Medical Imaging (such as
ultrasound and x-ray equipment), Clinical Care Devices (such as patient monitors and infusion pumps), Consumer Medical Devices (such as
blood-pressure monitors and heart-rate monitors), Healthcare IT (such as PACS and EMR) and Telehealth. We offer our clients global coverage
of the medical electronics industry, as well as dedicated reports on high growth regions, such as China, Eastern Europe, Latin America and the
Middle East.
About IMS Research (www.imsresearch.com)
IMS Research, recently acquired by IHS (NYSE: IHS), is a leading supplier of market research and consultancy to over 2500 clients worldwide,
including most of the world’s largest technology companies. Established in the UK in 1989, IMS Research now has dedicated analyst teams
focused on the factory automation, automotive, communications, computer, consumer, display, financial & ID, LED & lighting, medical, power &
energy, solar PV, smart grid and security markets. Currently publishing over 350 different syndicated report titles each year, these in-depth
publications are used by major electronics and industrial companies to assess market trends, solve marketing problems, and improve the
efficiency of their businesses.
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