While radiologists were busily attending to keynote lectures, scientific presentation and evening meetings, the recent Radiological Society of North America meeting Exhibit Halls were decked out and open for business. While I don’t give awards, I do try and observe trends and note-worthy events, both good and otherwise.

Busy, Busy, Busy
The first detail noted was the traffic in the halls; I’d call it good to excellent. The radiologists, technologists, administrators and investors took time to sample the wares of many booths. The traditional acre-sized mega booths of GE, Siemens, Philips, Kodak, Toshiba, Hitachi, Swissray, Agfa and Fuji were all back again this year, indicating that everyone expects 2003 to bring another year of solid spending in new capital equipment for almost every modality.

Printers have become a particularly hot area of competition, as the PACS networks make it so simple to hit the PRINT key. Knowing your options and alternatives is challenging but doable, ranging from high-volume to low-volume systems. The quality of the various systems is superb, with prices for almost every budget.

X-ray rooms continue to be upgraded to digital formats. While CR is everywhere, DR is gaining a foothold — especially in high-volume sites. Radiologists continue to maintain their comfort level with a wide array of technologies that have proven clinical applications, and DR appears to have matured to that stage now. While no one is hurrying to go totally CR or DR, the mix-and-match strategy for upgrading x-ray rooms is widely underway. The presentations by Fujifilm on new CR products indicates that CR is continuing to evolve and expand it’s range of applications. If CR-Mammo proves out clinically (and is cleared by the FDA), I would expect this to become widely deployed in the next few years.

Speaking of flat-panel x-ray, GE introduced the Innova 4100 for vascular procedures, stepping up in size from it’s hugely successful launch of the Innova for cardiac cath labs. I can hear the sound of cash registers ringing, indicating that market shares may be changing again in favor of GE. Shortly after the close of RSNA, GE announced the planned acquisition of Instrumentarium Imaging (~$1 billion in sales). Adding to the present $8 billion to $9 billion in sales reported by GE Medical, this addition opens up GE’s presence in the operating room and patient monitoring segments. If you think that surgeons and surgical procedures are due for a huge influx of technology (procedure, image guidance and information-based), then you may understand the benefits to GE’s acquisition. GE Medical is becoming more than just imaging and information systems these days. If it’s big enough and doesn’t bite, GE is probably ready to buy it. There is no other choice for a business this size to grow by 20 percent-plus per year, when the imaging market itself grows far less.

Continuing the PACS trend, more new first-time exhibitors appeared as well — indicating that the barriers to entry remain low, but the barrier to success (meaning profits) remains high. Most interesting was the recommendation to consider using SAN (Storage Area Networks) or NAS (Network Attached Storage) as the on-site archive method of choice. Maybe on-site juke-box archives have run their course. RAID price/performance continues to improve.

SourceOne, the newly formed combination of Diagnostic Imaging, Inc. and Marconi Healthcare Products, made it’s presence known at RSNA this year, too. Sporting an impressive range of capabilities in field service, consummables, supplies and capital equipment sales (now including PACS), this traditional dealer/distributor business appears to offer customers an updated version of products and services more in tune with the 21st century. With sales on the order of ~$2 billion, there is probably a business relation to review or consider with this company.

Ease of Use
It seems that the biggest challenges facing imaging operations today are workflow and productivity, especially getting the full range of benefits from the hardware or software that has been purchased. Traditional training programs seem to continually fall short of this mark, with most software being utilized to the lowest common denominator. Manuals don’t begin to address the need, and applications specialists are helpful, but spread thin. Are there any good examples of companies that have addressed this issue head-on? Let me know when you find one. The simplest things (e.g., user interface screens in PACS) seems the most confusing to me — they demonstrate that the developers want the world to work their way. Well, not all companies are this bad, but I think the point is well illustrated — you can judge many things about a company and its products by the level of attention that they pay to the user interface. Simple and intuitive operation is possible to achieve, but not by accident.

If you wish to look further ahead beyond 2003, check the SPIE Medical Imaging meeting presentations (www.spie.org). The industry researchers (both university and vendor-based) annually summarize their work in the sunny climate of San Diego, convening just after the Super Bowl this year. I think I might just find some time to update my knowledge base there again this year, or at least take a break from the frozen climate of the Northeast for a few days!

Doug Orr, president of J&M Group (Ridgefield, Conn.), consults with medical device companies in strategy and business development for emerging growth markets, notably radiology and cardiology. Comments and suggestions can be sent to dforr@aol.com.