VNAs Emerging in Global Markets

KLAS recently published a report looking for the first time at VNA deployments outside of the US. Needs in other countries and regions often vary from deployments in the US because of overarching regional initiatives that are tying together public entities to get economies of scale. In the US, we see less of this regional collaboration. Additionally, we see more organizations incorporating or wanting to incorporate non-DICOM content (such as XDS or PDFs). We at KLAS wanted to highlight the breadth and scale that these VNA vendors have been able to achieve and whether that covers a single organization, a few disparate organizations, or even entire regions or provinces.

The goal for the Global VNA Solutions 2019 report was not to get the average customer experience; especially where a lot of organizations may be using their VNA as a backup radiology archive. Rather, we worked with the vendors to interview leading customers around the globe to understand what is currently possible with these VNAs and which vendors are pushing the limits.

Vendor Scope and Performance 

The vendor scores in this report speak more to vendor consistency than their ability to scale. Sometimes a vendor that isn’t meeting all expectations still proves ability to scale.

There are some vendors that stand out in terms of size and scope for being able to scale the best. Philips recently acquired the Carestream solution that has proven its ability to scale in total archive size and the number of facilities and service lines connected. Their deployments outside the US tend to be broader in scope than their deployments in the US, and these leading organizations have very positive feedback about how consistent Philips has been. Fujifilm is similarly able to really scale and deliver. Agfa Healthcare has some of the broadest VNA deployments, but frankly, they’re just a little more inconsistent when it comes to hitting expectations.

On the smaller side of things, VISUS Health IT has very good technology and a very consistent experience. But they’re a regional player based in Central Europe, and their archive sizes are also smaller than other vendors’. There are a few vendors that are quite limited in scope that we only have limited data for. Mach7 has proven that they are able to do a region-wide deployment, but almost no one is storing non-DICOM images on their platform. Intelerad only has a few customers, and their breadth of deployment is generally limited.

Siemens is one other vendor that has proven the scale as well, though they are not getting brought up in new deals. They are relatively unknown, and I think some of that is because they've lost so much energy in PACS that people just don't know what they bring to the table with VNA.

The big takeaway here is simple. Providers really need to map out the scope of what they hope to achieve and then keep that in mind as they evaluate the vendors that are active in their region. This report really shows which vendors are able to tick the various scalability boxes.

To see more in-depth details on how well vendors partner with providers and meet other expectations, I recommend reading the full report.

Various Stages for VNA

It is hard to say where the market is as a whole because the non-US market encompasses so many countries and regions. Each country is at different stages with their VNAs. Some countries are very advanced. For example, The UK and Scandinavia have several regional archives in place. Canada also has several regional archives that cover full provinces—though they may cover primarily radiology images today, they are tying in dozens and dozens of facilities into a single VNA and making those images available across the province. Other countries have yet to fully leverage VNAs, letting organizations individually make the business case and deploy solutions to meet their own internal needs.

Generally speaking, we expect VNA to continue to grow in scope as organizations seek to reduce redundant infrastructure. Outside of radiology, cardiology is a frequent second choice followed by images from the OR, wound care, ophthalmology, dermatology, and even pathology. While very few are pulling in pathology images, many organizations see this coming on the horizon as the shift to digital is just starting to take hold in a number of countries (KLAS just published our first report on digital pathology as well). These changes will come, but it will take some time. Organizations have to remember that this is not just a technology project; it’s a very large change management project too.

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