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ECR meeting showcases European PACS idiosyncrasiesSmall firms share spotlight with major vendorsThe European Congress of Radiology, held last month in Vienna, provided a nurturing venue for European PACS vendors to showcase their wares.
Small firms share spotlight with major vendors
The European Congress of Radiology, held last month in Vienna, provided a nurturing venue for European PACS vendors to showcase their wares. The European PACS market contrasts dramatically with the way PACS are marketed in the U.S. While the U.S. market is almost exclusively the domain of the major film and modality vendors, the European market is considerably more fragmented. In the U.S., Siemens, GE, Agfa, and Cemax-Icon (Kodak) control more than 70% of the market share, while in Europe no single vendor or group of vendors dominates the market. Instead, each country or region has a dominant player (or players) that control market share in their respective areas.
European PACS player Tiani has a strong presence in Austria and Germany, sharing the market with Siemens, Tetenal, Image Devices, DK Systems, and others. Sectra, best known in the U.S. as a software supplier for Philips Medical Systems PACS, has an exceptionally strong position in its home base of Finland and Norway, sharing the lead in Scandinavia with Applicare and Cortree. Marconi has a dominant presence in the U.K., while Varay Laborix is strong in the French market.
An exceptionally large variety of teleradiology and PACS hardware and software components were on display at the ECR meeting. Free from the constraints imposed by the FDA, European dealers and distributors can create best of breed products that integrate software offerings of many firms from major developers like Applicare to minor vendors like Weinkom, Grafimedia, and Radin.
The major modality and film vendors presented integrated solutions that allow them to differentiate themselves from the smaller independent companies. In the U.S., GE has both a partnership and an equity position in clinical information systems vendor Cerner. But at the ECR, GE exhibited an internally developed Windows NT-based RIS that provides not only basic RIS functionality but digital dictation, voice recognition, Microsoft Office 2000 integration, and even paper scanning capability as part of its PACS. The product, called Medora 3.5, is slated to be in production in late May and available in the U.S. by years end.
Agfa showed new specialized software for both orthopedic and cardiac applications, although with a fairly high sticker price ($20,000 for each software package). Agfa also stressed its Basix entry-level, NT-based PACS configuration.
One of the biggest surprises at the ECR meeting was Fuji, which made a strong push for its Synapse PACS product, dedicating more than half its booth space to PACS.
Digital radiography (DR) seems to hold a high degree of interest for the European community. GE has an exceptionally strong installed base of digital radiography in Europe, with 15 sites up and running, and nine more slated to be installed in the coming months. This is nearly four times the total U.S.-installed DR base GE discussed at the Radiological Society of North America meeting in Chicago last November.
Trixel, the Philips/Siemens/Thompson Tube consortium, announced that commercial production of their long-awaited DR receptor will begin this month. DR vendor Swissray also had a strong presence, positioning themselves not solely as a DR vendor but as a solutions provider showing integration capability with Agfa, Cemax-Icon, Data General, Storecomm, and FileLink.
Compared to their showing at the RSNA meeting, Hologics presence was quite small. This was in contrast to Canon, which focused more than half its booth on DR and only a very small section on PACS, and showed Applicares software instead of its own PACS that is marketed in the U.S.
It was interesting to note such little discussion of the World Wide Web at the ECR, especially considering that Web use dominates virtually all discussions of U.S.-based PACS. This is no doubt due to the cost associated with using the Web in Europe. While flat rate Internet access (a single fee for unlimited use) is widespread in the U.S., this is relatively new in Europe. The European market is also still constrained by per minute calling charges associated with Web use, making Web-surfing cost-prohibitive.
Overall, Europe is about three years behind the U.S. in PACS development and is going through the same growing pains that the U.S. market did in years past. Economic arguments for PACS are becoming almost mandatory, requiring vendors to offer creative programs to overcome these barriers. Siemens Rent and Care, a program based on patient volume and usage, and per click and pay-as-you-go programs from Marconi, Philips, and GE are all now available. But PACS in Europe, while behind the U.S. in some respects, continues to move along at a steady pace, hindered only by the same economic restraints that are being felt worldwide.