GE/IBM PACS decision reflects shifting market

Picture archiving and communication system supplier Genesys seemsto have an exclusive hold on the use of IBM's RS/6000 Unix workstationsin medical PACS. This exclusivity, however, is one born of effortrather than legal contract.

"Over the past year and a half, every IBM PACS installationhas been a Genesys solution," said Michael Cannavo, presidentof Image Management Consultants of Winter Park, FL.

The small Orlando, FL, PACS software developer is the PACSsupplier of choice for IBM national organizations in Europe andLatin America. Genesys also now has a more open playing fieldin the U.S. and Japan for sale of its RS/6000-based ROI PAC system.This follows a decision by GE Medical Systems and IBM not to sella comprehensive PACS product this year (SCAN 4/22/92).

GE/IBM PACS technology is based on the two firms' long-standingIntegrated Diagnostics (ID) development effort. ID works-in-progresshave incorporated IBM minicomputer and PC systems, along withproprietary software coding for IBM computers and GE imaging systems.

Workstations running with Unix operating systems are centralto the open systems networking concept, which heightens connectivityamong computers through the use of standard, off-the-shelf technology.

The decision by IBM and GE not to sell their proprietary PACS"certainly validates that open systems are the way,"said Michael Kerouac, Genesys president. "Each departmentwithin a hospital--whether radiology, pathology or pharmacy--hasUnix-based solutions. This information must be tied together."

Although different versions of Unix are open, they are notidentical, Cannavo said. Genesys has spent time and effort tosmooth the porting of medical images and other data into the IBMUnix operating system on the RS/6000. Most open-system PACS integratorshave worked with the AT&T version of Unix used by Sun Microsystemsand other workstation vendors.

In addition to technical skills, it takes persistence and managementprowess to work well as an IBM business partner, Kerouac said.

"Anyone willing to invest the two to three years it tookme to be effective in marketing with IBM is welcome to do it.This is more an advantage of attrition than a marketing advantage,"he told SCAN.

The main market for Genesys' ROI PACS is found in hospitalsthat already use IBM computer systems, particularly as the basefor hospital information systems, he said.

"We (Genesys) can have an effect in hospitals with IBMsystems. Selling ourselves as a radiology solution against Siemensand Kodak isn't the way to raise the kids and put them throughcollege. Our customers are hospitals that see their PAC systemsas extensions of hospital-wide investments in information management,"Kerouac said.

THE GE AND GENESYS RELATIONSHIPS with IBM are fundamentally different,said Joseph L. Marion, PACS product marketing manager for GE MedicalSystems. IBM's RS/6000 workstation is a standard product developedby the giant computer company on its own. Genesys writes softwareto run on this standard platform.

Integrated Diagnostics, on the other hand, is a joint researcheffort through which the two firms are developing nonstandardPACS technology. This relationship would not prevent GE from offeringthe RS/6000 in its imaging system product line as well, he said.

"We haven't said we would not (sell the RS/6000), butthe type of relationship needed to take on that product isn'tthe same relationship that one would need to develop some of theproduct capabilities we have been looking at (as part of IntegratedDiagnostics)," Marion said.

While providing Genesys with most of its worldwide PACS businessto date, IBM is not committing itself to one vendor or one PACStechnology.

"They (IBM) are hesitant to commit to one-vendor solutionsagain," Cannavo said. "It is a wise business decisionto keep their options open."

Integrated Diagnostics evolved through several stages of productdevelopment over nearly 10 years, starting with records data,incorporating voice recognition and, finally, merging medicalimages, said Ronald M. Sedgley, the IBM manager responsible forIntegrated Diagnostics. No global PACS product has been releasedcommercially, but parts of the technology have become products,he said.

"We are continuing to work in this (PACS) area, but wedon't preannounce whether there are going to be products. FromIBM's standpoint, we are looking for system integration opportunitiesto serve the niche (medical) opportunities customers can justify,"Sedgley said.

On the medical imaging side, GE is apparently stepping backfrom an intention to offer its own global PACS. Instead, it willlikely take the same approach as Picker and Toshiba, which isto integrate with any vendor's equipment and act as a PACS consultantfor users.

"Out of the big five (scanner manufacturers), this leavesonly Philips and Siemens to battle it out as major PACS vendors,"Cannavo said.

Philips appears to be bouncing back from its own jettisonedglobal PACS effort with AT&T. Although the Dutch vendor isstill spending more than it makes in the PACS business, it isbuilding a good technical reputation in the marketplace, he said.

Siemens of Germany received a boost last year when it won amajor U.S. military PACS contract with its partner, Loral Aerospace.Siemens has brought in some related PACS business outside of themedical diagnostic imaging support (MDIS) project, but the imagingfirm's assessment of the overall benefit of MDIS awaits implementationof the first MDIS project sites.