Small vendors unite against behemoths

As large vendors continue to win the confidence of multisite enterprises, their technology development sets the agenda for smaller firms, which must address advanced capabilities or risk being perceived as technological laggards. Small firms are increasingly accomplishing this through alliances and acquisitions.

TeraRecon is an appealing ally, as its 3D server can be tailored to work with PACS from a range of vendors, including Agfa, Amicas, Sectra, Delft Diagnostic Imaging, and Intelerad Medical Systems. Interfaces are also proliferating for voice recognition products such as those from Dictaphone and TalkTechnology, and for document management such as the product from PACSGear.

Small companies are working together to reach beyond radiology. Amicas and Heartlab have integrated the Amicas Vision Series PACS and Heartlab Encompass cardiology PACS. (One of the larger vendors, Agfa, also has a working agreement with Heartlab.)

But acquisitions, such as the purchase of Cedara Software by Merge eFilm, have an innate appeal because they offer control over the development of technology and its integration with PACS. Among a spate of such acquisitions were two involving vendors now in the spotlight for their own merger. Merge eFilm purchased AccuImage just months ago to gain access to 3D capabilities, and Cedara Software acquired PACS vendor eMed in October.

But consolidation in the PACS industry is nothing new, nor is it restricted to small vendors. Three years ago, McKesson acquired ALI Technologies and integrated that company's PACS with its own IT system. Last year, Kodak bought Algotec, a small company that had supplied PACS for Kodak rebranding.

These acquisitions and alliances ratchet up the level of competition, potentially improving technology and reducing costs, but they can also drive smaller competitors from the market. Canon Medical Systems dropped out of PACS about a year ago. Although the company, which now focuses on digital radiography, continues to service its installed base of about 100 sites, it is not selling PACS to new customers, according to a company spokesperson.