Trends in radiology enterprise imaging systems

Isaac Zaworski, president of Sectra U.S.A. Inc., recently spoke with Radiology Business about trends and concerns from his from customers at the Radiological Society of North America 2023 meeting. 

Radiology departments are facing mounting pressure on capital budgets, exacerbated by diminishing reimbursements and escalating personnel costs. Post-COVID there also has been a persistent and growing shortage of radiologists and technologists, which has significantly strained healthcare institutions, necessitating a reevaluation of infrastructure and operational strategies. Enterprise imaging informatics systems are playing an increasing roll to help boost efficiency in radiology workflows to help offset these issues. 

"There has been a big push to look at how to modernize infrastructure to realize efficiencies at the broader enterprise organizations level. So we see a lot of trends of organizations that are looking to make the pivot into managed services and to transition out of hosting on-prem major IT infrastructure projects," Zaworski explained. 

Cloud key for efficiencies in enterprise imaging systems

These managed services are all hosted on the cloud, which provides not only off-site, managed data storage, but also software as a service offerings. This includes enterprise imaging PACS and access to advanced visualization, subspecialty reporting modules, and the ability to access artificial intelligence algorithms integrated into the radiology workflow. The advantages of this are immediate updates for the software on a regular basis, access anywhere via web connections, elimination or reduction of maintaining on-site servers, increased cybersecurity, and the ability to off-load some tasks from hospital IT teams.

"We as an organization invested many years ago in pivoting our infrastructure into managed service offerings because we saw this trend coming," he said. "It was inevitable and it has happened in other industries. The shift from big capital purchases into ongoing consumption-based subscription models where organizations can scale as they grow and pay for the services that they actually use is here to stay."

Key trends in enterprise imaging

Zaworski said there are multifaceted challenges confronting healthcare systems today. Cloud and managed services offerings can help simplify IT needs, lower costs and improve efficiencies. 

One of the predominant trends identified was the drive toward modernizing infrastructure through cloud-based managed services. He said organizations are veering away from on-premises IT infrastructure projects, opting instead for flexible, consumption-based subscription models. 

The acceleration toward managed services was notably hastened by the COVID pandemic. Zaworski said the transition has snowballed and Sectra forecasts a near-universal adoption of fully managed service offerings among new customers within the coming year. Additionally, Sectra is actively working to transition existing clientele into this model over the coming years.

This is partly being driven by the rapidly rising need for larger image storage archives due to increasing numbers of CT, MRI and breast tomosynthesis exams that often include hundreds of image slices. Digital pathology is also a data-heavy undertaking, with its use continuing to grow. Cloud offers a more cost-effective way of storing these large datasets.

"Storage costs are a huge concern. As we look forward, we see digital pathology as an example starting to really take hold in the U.S. market. Image sizes are huge. Storage costs are on the front of everybody's mind, and the reality is the cloud storage costs when it comes to large files that need to be archived for a long time, can't really be competed with on-prem in any way, shape or form. So, that makes the ROI more straightforward at this point in time," Zaworski said.

Cybersecurity also is another top-of-mind consideration for imaging leaders. Most hospitals do not have 24/7 staff monitoring for IT security breeches, but large cloud storage companies do. In today's world where ransomware is a major concern for healthcare institutions, which have become the No. 1 target of these cyberattacks, cloud makes a lot of sense.

Zaworski stressed the importance of partnering with specialized security providers like Microsoft to fortify institutions against evolving cyberthreats, allowing hospital IT teams to focus on other projects at their institutions. 

Leveraging AI and IT to overcome staffing shortages

Addressing the shortage of radiologists and technologists through enhanced workflow efficiencies powered by artificial intelligence has become a key discussion point with customers, Zaworski said. Beyond the conventional use of AI in image interpretation, the spotlight shifted toward leveraging AI for automating and structuring report data. He highlighted the potential of generative AI models in enabling radiologists to articulate their interpretations naturally, while AI algorithms autonomously structure the reports, significantly expediting the diagnostic process.

"We are demoing some really early prototypes where we can automatically structure report data without forcing the radiologist to conform to a structured template, clicking through a lot of boxes and ticking through things," he said. "They can just speak naturally, interpret in a way that focuses on the images and is comfortable to them, and then use the generative AI technology on the backend to pick out the relevant details and automatically structure them into reports that then add a whole lot of value downstream in the overall diagnostic chain."

Sectra also has integrated a number of AI vendors and third-party apps into its enterprise imaging system, which has garnered substantial interest. The emphasis has shifted from AI's theoretical validation to deploying stable algorithms at a production scale, empowering healthcare institutions to seamlessly integrate AI into their clinical workflows and realize tangible benefits.

"Now we're starting to see the point where algorithms are stable enough that organizations are deploying this at scale in a production environment. That's where our focus is really, to provide a comprehensive platform that enables a secure and consistent experience for the customers to plug and play algorithms from a number of different vendors, as it makes sense for their clinical workflows," Zaworski said. "We also provide the tight integration from a user interface perspective so that the clinicians, doctors and the technologists can actually interact with the findings."

Find further enterprise imaging news and more RSNA news and video.

Dave Fornell is a digital editor with Cardiovascular Business and Radiology Business magazines. He has been covering healthcare for more than 16 years.

Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail:

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