Cannibalisation of RIS has driven new wave of specialist demand While this complexity is inherently “baked-in” to radiology, there are some functions and areas of radiology IT software that have become more commoditised. For example, imaging order entry and basic workflow scheduling for imaging modalities, long the mainstay of specialist RIS systems, have often been replaced in favour of an EMR vendor RIS module. Most EMR RISs have solid functionality in handling the basic operational processes for a radiology department and enabling enterprise-wide access and diagnostic report/patient record integration. Cannibalisation of standalone RIS systems by EMR vendors has been relatively widespread over the last decade, especially in the U.S. where the confluence of regulatory enforcement and market economics resulted in mass hospital M&A activity into larger networks. Consequently, the standalone specialist RIS market declined year on year.
Yet this shift has not had the desired effect expected by commissioning hospital executives. In fact, the reactionary impact of this decision to use EMR over specialist RIS has been quite profound. Many of the nuanced tools and features of standalone RIS were missed by radiologists and technicians; speciality functions such as modality protocol management, smart enterprise case-load balancing, staff QA, fleet management servicing and so on were all missing from EMR RIS offerings. Moreover, with more access to operational data from the EMR roll-out, hospital leaders are today realising that imaging has a major role in care operations, as both a profit and loss centre. And it has even more of a bearing on clinical outcomes.
The result of this cannibalisation? A new wave of specialist stand-alone workflow and operational products for radiology has emerged, with a clear migration of radiologist workflow tools from RIS products toward radiology PACS, which in general has been far less impacted by the EMR. Leading imaging IT vendors have also been quick to jump on this trend, especially as focus on operational efficiency, cost saving, and care outcomes have become more important in today’s regulatory environment. The sudden acquisition spree of specialist workflow software vendors such as Primordial (Nuance), Medicalis (Siemens Healthineers) and Clario (Intelerad) and product launches of workflow, operational and business intelligence tools from leading vendors, is spurring robust new market demand (see chart); this can only reinforce the argument that EMR-based RIS has so far not been able to meet the complex needs of radiology.
