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Cardiology 2021
Opportunity for Market Disruption (A Decision Insights Report)
Author
Monique Rasband
Author
Emily Paxman
Author
Sam Eaquinto
While enterprise imaging (EI) is on healthcare organizations’ minds, many currently use multiple vendors for different imaging needs. For cardiology in particular, organizations frequently must piece together multiple systems to meet their structured reporting needs. Today, a number of organizations are replacing their legacy cardiology solutions and/or evaluating cardiology in the context of their long-term EI strategy (including structured reporting in the CVIS). No cardiology offering stands out with great customer satisfaction—each of the last three years has seen a different vendor win Best in KLAS for cardiology. This report examines 38 recent cardiology purchase decisions and the factors driving these decisions.
Data in this report comes from two sources: KLAS Decision Insights data (information on which vendors are being replaced, considered, and purchased and what factors drive these decisions) and KLAS performance data (quantitative ratings on metrics like functionality, ease of use, integration, etc.). For more information, see the About This Report section.
Philips, IBM Watson Health & Fujifilm Most Often Considered
Purchase considerations are spread across many vendors, but Philips (considered in 39% of measured decisions), IBM Watson Health (also at 39%), and Fujifilm (at 34%) are most commonly considered. Philips and IBM are each chosen or indicated as the likely choice in roughly one-third of decisions where they are considered.
Several interviewed organizations have either selected Philips IntelliSpace Cardiovascular or say it is their likely choice. Integration and vendor expertise are common drivers in these decisions. Many considerations of Philips come from the vendor’s large legacy Xcelera customer base. Two of the six organizations who have chosen/will likely choose IntelliSpace are prior Xcelera customers, and the rest are moving from Agfa HealthCare (two), ScImage (one), or GE (one). Philips is up for possible replacement by several existing clients, mostly Xcelera users who say the product will no longer be supported. Two possible replacements are from IntelliSpace customers, both looking to consolidate their cardiology vendors; one also mentioned UX issues and insufficient support.
The major factors for organizations that choose IBM Watson Health for cardiology include integration, functionality, and prior experience with the vendor. With their full enterprise imaging suite, IBM is often considered by larger organizations and others hoping to consolidate their imaging vendors. When IBM is considered but not chosen, respondents cite reasons including price, physician preference, and hesitancy about IBM’s acquisition of Merge. The handful of current clients looking to replace IBM cite poor vendor/client relationships.
Fujifilm is considered in about one-third of decisions but was only selected once in this research sample. This single organization appreciated the solution’s ease of use and cardiologists’ ability to read studies from anywhere. When Fuji is not selected, respondents often cite clinician preference for other solutions. Fuji has been ramping up their new platform for quite some time—a few providers have spoken to KLAS about the beta experience, but no live customers have yet been validated. Some organizations are optimistic about the new version, while others feel Fuji has been too slow to deliver.
Agfa HealthCare, GE Healthcare & Change Healthcare See Less Momentum
Five interviewed organizations are considering replacing Agfa HealthCare; these clients are on the legacy IMPAX Cardiovascular solution and report strained relationships as a result of past negative experiences. No respondents in KLAS’ Decision Insights data have selected or indicate they are likely to select Agfa, though KLAS has validated several newer customers in our performance research. GE Healthcare replacements are mainly for their legacy DMS solution. Reasons cited include prior experience, relationships, and cost. GE Healthcare’s newer cardiology platform (Centricity Cardiology Enterprise Solution) generates higher satisfaction from live customers. Organizations looking to replace Change Healthcare would like to consolidate cardiology vendors and are aiming to avoid challenges integrating with Epic.
When Considered, Epic & ScImage Often Selected (Usually in Combination with Other Vendors)
Epic and ScImage are less commonly considered than other vendors in this research, though they are often chosen when considered. Epic, whose solution lacks a cardiology archive, is typically chosen for integration with the EMR enterprise suite, along with their culture of partnering with organizations and solid workflows for features—the exception being structured reporting, which is a historical weakness. ScImage was selected by several smaller organizations (<400 beds) for cardiology imaging storage; reasons include price and, according to doctors, the system’s simplicity and ease of use.
Integration, Functionality & Cardiologist Preference Drive Selections & Replacements
Organizations making purchase decisions most often cite integration and functionality/technology as major factors influencing their decisions. Cardiologist preference is another key factor, affecting almost 20% of validated purchases—a much higher rate compared to other types of solutions KLAS measures.
Respondents offer several different reasons for wanting to replace their current solution. Many hope to get improved functionality, especially in structured reporting. Others aim to consolidate the number of vendors they deal with by moving to an enterprise suite. Several organizations report their current products are nearing their end of life. Some others are dissatisfied with their current experience and their vendor relationship.
Philips, Epic, IBM Watson Health Selected Most by Large Organizations
Philips, Epic, and IBM Watson Health are most often selected by larger organizations (500+ beds) in new purchase decisions. In terms of vendors’ existing customer bases, KLAS has validated that all measured vendors have a mix of larger and smaller customers.
Vendor Summaries
Considered in about one-quarter of decisions in this research, selected in one. KLAS has also validated two additional recent wins through other research. Many respondents are familiar with and have had prior experience with Change Healthcare. Current clients appreciate the ease of use. Rated lower for delivery of new technology and supports integration goals. Change Healthcare has started sharing their vision for cloud products; KLAS has yet to validate live customers. 80% of interviewed clients would buy again.
“We are getting a new product that claims to be on one database and very simple. I am hopeful that the vendor is right about that. Change Healthcare’s product seems good. It is in multiple centers, and I have talked to people who use the product, so I have gotten some feedback on how it works. The vendor seems very committed to making the system work for our hospital.” —Manager (selected Change Healthcare)
“Structured reporting is a big need for us. Some other vendors offer better integration with structured reporting in Epic’s system than Change Healthcare. Overall, the Change Healthcare suite meets our needs of today. But in terms of partnering with us to improve our overall programs, I just don’t think that Change Healthcare is there yet.” —VP/executive (replacing Change Healthcare)
Considered by KLAS to be a component product because Epic does not currently offer a cardiology PACS, and many customers use the Epic cardiology system not as their CVIS but as an extension of the EMR and other cardiology tools. Gaps in structured reporting result in many organizations supplementing with other vendors. Prospective clients say Epic is up front about the product’s capabilities and the build effort required by organizations who leverage Cupid for structured reporting. Many would appreciate more product development and more complete templates. Current customers (mostly using Epic for scheduling and registry reporting) cite integration as main satisfier. Some feel Epic has not sufficiently developed the product and that it still lacks needed functionality. Some clients also feel they don’t get their money’s worth.
“There were people in our institution who thought that having everything in Cupid would be a better option than using our last system. That way, all of the data that we wanted to acquire and accumulate would be in one system, and we wouldn’t have to pull data from other systems and then export it into Epic’s EHR.” —VP/executive (selected Epic)
“We thought we would be down the road with Cupid by now, but each time we evaluate it, it doesn’t seem ready. We have started to build out structured reporting with another vendor due to timing. We have shifted from using Cupid for structured reporting to using it just for scheduling. Epic also offers a lot of open text fields. When it comes to mining the data, open fields aren’t great.” —Analyst (did not select Epic)
Fujifilm is considered often thanks to a perception of strong functionality and technology. Ease of use, integration benefits, and the vendor’s enterprise imaging suite are other reasons for consideration. Infrequently chosen (selected by one organization in this report sample). Respondents who don’t choose Fuji say cardiologists prefer other systems. Current clients’ satisfaction varies; most customers are satisfied, a few are highly satisfied, and a couple are dissatisfied.
For imaging, we are going with Fuji’s cardiology solution. Through the RFP, the decision basically came down to ease of use. Fuji had their platform go to a zero-footprint client for even our cardiologists to do their reads, so the ability to read from anywhere looked very promising to the cardiologists. We are going to do all our structured reporting through Cupid. Fuji’s integration with Epic and having Cupid be the cockpit for our cardiologists just looked like the right match for us.” —Manager (selected Fujifilm)
“When our old cardiology vendor needed to be replaced, we did look at some of what Fuji could do as part of our evaluation. We went with another vendor in the end because that was what the cardiologists preferred.” —CIO (did not select Fujifilm)
GE Healthcare is considered because of their reputation and full suite of both imaging IT solutions and equipment. When not selected, respondents cite relationship issues and past negative experiences with the vendor, along with cost. Some current customers feel the new cardiology solution (Centricity Cardiology Enterprise Suite) is an improvement over the legacy solution. They also mention more willingness from the GE Healthcare team to work with customers. Less-satisfied clients describe inconsistent support and feel GE Healthcare could be more proactive about reaching out.
“Our hospital system was a GE-favored system, so a lot of our modalities and clinical systems were already on the GE platform.” —Manager (selected GE Healthcare)
“Our decision to leave GE Healthcare is a financial one. In order to continue using GE Healthcare’s product, we would need to move to their Windows 10 Centricity CCW platform, and that would include a cost. Moving to another vendor just makes a bit more financial sense, so that is really what is driving the decision.” —Analyst (replacing GE Healthcare)
IBM Watson Health ties with Philips for the most considerations in this research (considered in 39% of validated decisions). IBM’s full suite of functionality, prior experiences with the vendor, and ease of use are common consideration factors. Merge Cardio has a track record of physician adoption of structured reporting and a proven ability to scale to large organizations with high volumes. Customer satisfaction has remained steady over the past year. Clients say the product works as promoted. Some respondents have experienced implementation challenges; others would like to see continued innovation from IBM.
“We have engaged Merge for structured reporting because we already have their system for our echo modality. We are looking at them for the rest of the modules. Then we will interface results and procedure logs back into our EMR.” —Analyst (selected IBM Watson Health)
“Merge Cardio is good, suitable, and up to date, but anytime we need to change the structured reports or build new reports, we have to get professional services from IBM Watson Health. That makes it challenging to keep a standing budget, and that is a problem. We aren’t looking to entirely move away from Merge Cardio, but we may be moving our structured reporting out of Merge Cardio. A lot of the decision driver is registry compliance. We are getting a lot of input from our registry folks about data elements that they can’t find.” —Manager (replacing IBM Watson Health)
Considered in 39% of decisions, Philips ties with IBM Watson Health for highest consideration and leads with the highest number of wins/likely selections (6) in this research. Reasons for choosing Philips include integration, expertise, and cardiologist preference. The vendor’s overall enterprise imaging road map is unclear for some clients. In 2019, acquired Carestream and their VNA; some customers concerned that there have been so few large-scale implementations of the acquired VNA. 75% of interviewed clients would buy the Philips cardiology solution again.
“From what I have heard, we are moving to Philips. There are a lot of things that have made us choose Philips. They have an HTML-agnostic platform, and the product allows remote users to read with a full suite of tools. There is a particular structured reporting, and the timeline features were appealing to the end users. We have a lot of Philips equipment, and integration with the equipment is more seamless with Philips, though it can be accomplished with other vendors. We didn’t see any glaring issues.” —Analyst (selected Philips)
“Currently, we have multiple enterprise imaging vendors. We would like to get down to one system. As a result, Philips’ product will be replaced. We wouldn’t buy IntelliSpace Cardiovascular again because the system has been a user-experience downgrade. We have had to use workarounds. Philips’ support has gone silent. Philips put the product in, and then they were out. We haven’t known anything because nobody from Philips has reached out to us.” —VP/executive (replacing Philips)
Organizations considering and selecting Siemens Healthineers say pediatrics functionality is strong. Siemens Healthineers also benefits from name recognition because of their long history in cardiology and in imaging equipment (respondents describe the latter as reliable and solid). Two organizations report replacing Siemens; both cite lack of innovation. Current customer satisfaction is mixed—there are several highly satisfied respondents alongside a large group (25%) of dissatisfied clients. Siemens rates lower for proactive service and executive involvement. Ease of use and support are relative strengths.
“Our users are consistently averse to change, and they really feel that they are getting enough value out of syngo Dynamics. A perceived strength of syngo Dynamics is that it does address the particular subset of the pediatric population with anomalies of congenital heart disease.” —Director (selected Siemens Healthineers)
“One of my biggest complaints is that Siemens is not innovating. The product hasn’t moved enough in the last five years to really keep up with what we are seeing from [other vendors]. Siemens is not bringing out new functionality. The product just tends to be the same thing year after year.” —Director (replacing Siemens Healthineers)
Other Vendors in the Cardiology Space
The following vendors have come up in KLAS Decision Insights research over the last two years but are not rated for performance due to insufficient data.
Agfa HealthCare: Considered in 18% of decisions because of their overall enterprise imaging strategy. Replacements are from legacy IMPAX Cardiovascular customers, some of whom report strained relationships. Cardiology solution reported to work well with outside hemodynamics solutions. Integrates with Ascend.
INFINITT: Small customer base in cardiology. Single database for all imaging solutions, including cardiology, PACS, and VNA. Rarely considered; no selections in this report sample.
Intelerad: Acquired Digisonics in 2020 and LUMEDX in 2021; both solutions rarely considered in validated purchase decisions.
Medstreaming: Rarely considered in KLAS data. Being replaced by two interviewed organizations and considered by one.
ScImage: Considered in 13% of validated decisions and selected by several smaller organizations (<400 beds)—some for cardiology imaging storage, others for structured reporting. Price and ease of use were deciding factors.
Sectra: Cardiology PACS only (does not include structured reporting). Reporting often done through Epic Cupid or partnership with Ascend. Cardiology PACS customer base growing, but Sectra is rarely considered in new decisions that include structured reporting.
KLAS’ Decision Insights data conveys the future plans of current and potential customers in a given market segment. When a provider organization reports they have made a solution change in the last 12 months or plan to do so in the next 24 months, that decision is captured in the form of Decision Insights data. Decision Insights data does not represent a comprehensive census or win/loss market share study. Rather, it is intended to help provider organizations understand which vendors have market energy and why.
About This Report
Data for this report comes from two sources: (1) KLAS Decision Insights data and (2) KLAS performance data.
KLAS Decision Insights Data
All references in this report to organizations’ purchasing motivations come from KLAS’ Decision Insights data. Since 2017, KLAS has been gathering information as to which vendors are being replaced, considered, and purchased and what factors drive these decisions. KLAS Decision Insights data does not represent a comprehensive census or win/loss market share study. Rather, it is intended to help provider organizations understand which vendors have market energy and why. The data in this report was gathered between May 2019 and May 2021 and covers 38 purchase decisions.
KLAS Performance Data
Each year, KLAS interviews thousands of healthcare professionals about the products and services their organizations use. These interviews are conducted using a standard quantitative evaluation, and the scores and commentary collected are shared online in real time so that other providers and IT professionals can benefit from their peers’ experiences. To enable readers to more quickly understand high-level differences in vendor performance and give better context as to how each product compares to other offerings in the market, KLAS has organized the questions from the standard evaluation into six customer experience pillars—culture, loyalty, operations, product, relationship, and value.
Product Designations Used in This Report
Component [C]: Product that typically includes most but not all components that comprise a complete system or that serves only a subset of the market. Epic’s cardiology solution is marked as component because Epic does not currently offer a cardiology PACS. Additionally, many customers use the Epic cardiology system not as their CVIS but as an extension of the EMR and other cardiology tools.
Writer
Amanda Wind Smith
Project Manager
Natalie Jamison
This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.