The 2005 PACSman Awards: This PACS is your PACS, this PACS is my PACS

Nov 29, 2005

CHICAGO - Welcome to SCAR 2005. No wait … SCAR was held in my hometown of Orlando this past June and the temperature wasn't nearly this cold. This is RSNA 2005, although it certainly seemed like SCAR. With PACS being shown, used by, or incorporated into nearly two-thirds of the 720 vendors at this week's RSNA show, this might have well have been SCAR.

"What's new, what's hot?" is the inevitable question everyone asks each year, but PACS is more like Pompeii than Mount St. Helens -- constant venting and steady dome building are seen much more often than the infrequent yet highly impressive pyroclastic explosions.

All year long we hear rumblings and signs of change from vendors, yet nothing really explodes with PACS like 3-tesla MRI and dual-source CT does in the marketplace. PACS just plugs along doing its job as more people wake up to the reality that PACS is more than just a toy. That's probably why the U.S. market finally exceeded $1 billion in sales this year, albeit a decade later than had initially been predicted by the industry's chief prognosticators back in the early '90s.

Both computed and digital radiography (CR and DR) are now must-haves for everyone considering a PACS implementation. Pricing continues to drop for CR as new uses for it expand, and DR is starting to make inroads in the market as well despite its higher pricing. Phased system implementation has all but gone by the wayside, with many facilities choosing to go "film today, filmless tomorrow." Replacement PACS installations now make up 25% of the market, opening up other opportunities for vendors offering data migration services, offsite storage, and other products and services.

Management of full-field digital mammography (FFDM) images has been an incredibly very hot topic at this year's meeting, and is sure to increase in acceptance despite the challenges of dealing with mammography's large file sizes, data compression restrictions, and high technology entry costs in a market that many consider to be a loss-leader from technical and professional reimbursement perspectives.

A few technological advancements were shown this week, including tabloid-size paper prints for less than 10¢ per copy (less than 15¢ for color), more cost-effective Web-based solutions, and presentations of integrated clinical systems (RIS/PACS/cardiology PACS/electronic medical records, etc.). I'm sure I missed a few hot products and will no doubt hear about it from the vendors who think they have created the Holy Grail, but there is only so much you can see in so many days. Besides, I was having too much fun finding fodder for the PACSman awards, which this year as in year's past was easily available.

It never ceases to amaze me how companies can spend nearly half their trade show budget on a single show and never proof a story board, a brochure, or even a product name. Many of these rival Chevy's Nova mistake of the early 1960s, when the company wondered why sales of a car that was so popular in the U.S. were flat in South America, until it was explained to them that in Spanish "No va" meant "Won't go."

Some of the products I saw this year were "No va," some never made it out of first gear, while most others will be content to just get in drive and never exceed the speed limit. All are fun though, as was this year's show, my 22nd. With that in mind, here are 2005's PACSman Awards, tongue-in-cheek and done in fun, but amazing nonetheless.

The "PACS by Any Other Name" Award
To the company that refuses to call PACS by its proper name and thinks the marketplace understands their internalspeak. Would it be so hard to put up a hyperlink to the word "PACS" in your pull-down menu on your Web site for those of us who haven't been reimagined yet, instead of trying to figure out what you call PACS?

The "If It Ain't Broke, Don't Fix It" Award
To those who are mounting a campaign to rename PACS. This is reminiscent of the effort in the early 1990s to rename PACS IMAC (image management and archive communications), which failed miserably. Call it DHIMS, IMAC, or whatever else you wish -- a PACS by any other name is still PACS.

The "Baby, You're the Best" Award
To the teleradiology services provider that quotes an "unbiased study" that rates them as No. 1 -- until you find out the company they used to conduct the study is also co-marketing an audio conference with that very same "top-rated provider" on … um … Credentialing Teleradiology Providers. "Desperate Housewives," anyone?

The "RonCo Veg-o-Matic" Award
To the vendor that, in the tradition of the Veg-o-Matic, now gives us Read-o-Matic, Slice-o-Matic, and DICOM-o-Matic.

The "How to Instill Confidence in Your Product" Award
There were three contenders this year in this category:

The "Ernest and Julio Gallo" Award
To the modality vendor that called their new MRI product "Grappa," obviously not recognizing the harsh-tasting wine by the same name made from grape skins that tend to leave a very foul taste in your mouth afterward. This is generally not something you want to equate with a multimillion dollar purchase.
The "ADD" Award
To the company that used the words "in the attention span of a child" when talking to radiologists about how long to will take them to learn their product.
The "Macintosh" Award
To the company that, in explaining its use of Linux, says, "There aren't so many Linux users, so it's not a target" of hacking. Gee, that makes me feel so much better now.

The "Class Act" Award
To the vendor that ended a decades-long relationship with a major modality manufacturer on a positive note, never badmouthing its former partner and going out of its way to ensure that its customers were taken care of properly.

The "Fred G. Sanford" Award
To the company whose overhead lights kept changing color while I was in their booth, with the last color change to an intense bright white. When you get to be my age, seeing a bright white light is not considered reassuring. I wanted to grab my chest and yell out, "I'm coming Elizabeth!!!" But alas, the colors changed again and my anxiety passed.

The "David Bowie/Eagles" Award
To the vendor in whose booth I couldn't help but feel like Major Tom in David Bowie's "Space Oddity," yet trying to find the booth exit felt like I was in Hotel California ("You can check out any time you like, but you can never leave…").

The "Rad-glish" Award
To companies that have created new words from concepts -- nighthawking, DICOM-plementary, Imag-osis, Leg-a-citis, etc.

The "Woody Guthrie" Award
To the company that feels that its PACS is our PACS. Group sing-along: "This PACS is your PACS, this PACS is my PACS … this PACS was made for you and me…."

The "Bee Gees" Award
To the developer that must have been listening to '70's disco music when they came up with the name JiveX for their PACS product.

The "Boys and Their Toys" Award
To the vendor that had the biggest crowds of anyone at RSNA -- offering a $299 digital camcorder, with over 1,000 sold on the first day.

The "Talent Knows No Boundaries" Award
To the air band guys, who include purchasing, engineering, marketing, customer service, and the limo driver in a band that every year keeps getting better and better.

Honorable Mentions
Special mention kudos to software engineers Alexandr Kogan and Pat Mougkolwat from Northwestern University Medical School's Imaging Informatics Department for creating the IHE Portable Data for Imaging (PDI) Passport, a standard for importing and exporting image and text data on a CD. These individuals wrote the code in less than 90 days, less time than most major vendors would have taken to set up a meeting to discuss the concept. Nobody told them it couldn't be done, so they just did it. Twenty vendors have already written to the standard, with many more to follow.

And this year's winner of the PACSman Award ...
The "I Know Rads Were Cheap, But" Award to our host. We are all looking for a great deal on hotels, but even some of the rads I know would draw the line at staying at a $35 a night youth hostel. Can you imagine a group of rads sitting in a circle in their boxers after a night of drinking singing "Kum by Yah"? That would be worth the price of admission alone.

See you next year!!!!

By Michael J. Cannavo
AuntMinnie.com contributing writer
November 30, 2005

Michael J. Cannavo is a leading PACS consultant and has authored nearly 300 articles on PACS technology in the past 15 years. He can be reached via e-mail at [email protected].

The comments and observations expressed herein do not necessarily reflect the opinions of AuntMinnie.com, nor should they be construed as an endorsement or admonishment of any particular vendor, analyst, industry consultant, or consulting group. Rather, they should be taken as the personal observations of a guy who has, by his own account, been in this industry way too long.

Part VI: Exploring PACS Secrets -- State of the Market, October 10, 2005

Part V: Exploring PACS Secrets -- Buyers and Sellers, December 16, 2004

The 2004 PACSman Awards, December 1, 2004

Part IV: Exploring PACS secrets -- RSNA edition, November 18, 2004