For years, I have heard providers lament at the slowing (dormant?) pace of innovation in PACS and RIS from established vendors.
Why might this be happening?
It could be that the current architectures have reached their limits. It could be that, with the saturation of PACS in mature markets, vendors are reducing R&D investment in this area. It could be that they can’t sustain the talent needed to innovate, losing creative and skilled people to more interesting/promising areas of IT. It could be innovation-suppressing regulatory burdens. Or the shift of spending to support staff in order to sustain the now sprawling installed base.
Regardless of the root cause(s), I see the emergence of interest in start-ups (such as those in the SIIM Innovator Alley) and open source projects (as seen by the steady traffic at the SIIM Open Source Plug Fest) that attempt to solve problems that the larger vendors appear not to be interested in solving. It seems providers are starting to accept that they are not going to get everything they need from their incumbent PACS vendor in today’s EMR-enabled, Cloud-hosted, analytics-driven, enterprise-accessible market.
Of course, the challenge of the start-up is breaking into the provider’s enterprise where the incumbent vendor may put up some resistance (overtly or passively). And open source is only as good as the staff (or paid service provider) you have installing, integrating and supporting it.
The informatics skills and knowledge provided by SIIM are more important than ever. If SIIM is to continue to lead in providing its members the knowledge and skills they need to survive and succeed, it will likely have to adapt how it organizes the materials to align with new and evolving learning goals. It also needs to adapt the medium by which its members learn, providing focused, on-line options where travel policies and budgets mean attending the annual meeting is not feasible.
I believe in the SIIM strategic plan and am wholly committed to helping the society that has helped me so much over the years thrive.
Don K Dennison 
Don,
I believe you are right with your statements. I believe that IT means flexibility and open source is prove of it. However – don’t you think that using open source in medical world (I mean open source HE IT solutions) are shifting clinical/medical risks from vendors to end-users? What about bug potential and its “removal”…for PACS,EMR&EHR etc. it is quite risky…
Regards, Tomasz
Hi Tomasz,
You raise an important point. Regardless of whether a solution is open source or a proprietary, commercial solution, someone needs to stand behind it.
Code without someone that knows how to support it, extend it, adapt it (to handle inevitable platform, environment and data changes) is at risk, no matter how high the quality of the design/implementation.
An application without someone that knows how to troubleshoot it, configure it, upgrade it, interface with it and train users on it, will not be effective.
So, the question is whether a provider can develop and retain staff that can keep a system based on open source software operating effectively, or if they will need to depend on qualified staff from a vendor. The answer for each provider depends on the decision maker’s confidence/desire to provide IT services, or stick to healthcare services.
I will say that the advantage of outsourcing the IT services to a vendor is that if they fail to perform, the provider can opt to not pay the the vendor. Dealing with ineffective IT services provided by full-time employees can be more difficult to resolve, depending on the employment rules in the provider’s jurisdiction.
I will also say that, in my opinion, IT services provided by the vendor are not guaranteed to be of higher quality than those by qualified provider IT staff. I have seen users of products know much more about a product than the vendor staff assigned to support the provider’s system (which is depressing for both parties, I am sure).
[…] environment as you would before the PACS “gold rush” of the mid-2000′s? I touched on this in a blog post a year ago after attending the SIIM 2013 Annual […]