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The revival of RIS: will RIS investments no longer take a backseat to PACS?

KLAS asks: Why did FUJIFILM recently acquire Empiric Systems, a radiology informatics vendor, when FUJIFILM's own imaging offerings have done quite well in the industry without a complementary RIS module? Why is McKesson deploying a new RIS solution, Horizon Radiology Manager (HRM), just a few years after the release of a new version of Siemens Novius RIS/syngo Workflow? Other vendors are following suit; Philips is rolling forward with the XIRIS work flow solution, Carestream is pushing a new version of its RIS, and Agfa is attempting to adapt its RIS offering for the U.S. market. Why has there been a sudden revival of RIS technologies?

The advent of PACS revolutionized the workflow and efficiency of imaging departments across the country. Healthcare providers turned to this new technology in droves, causing imaging vendors to also pay ever-increasing attention to the PACS market. As a result, PACS proliferated while investment in RIS tools languished, and PACS-driven workflow took hold in the industry. It seemed that PACS was going to co-opt most RIS functionality.

Hospitals have realized that PACS is not the complete workflow driver originally hoped for. PACS does not traditionally provide data integration with the hospital CIS. Though PACS enables dramatic increases in imaging volumes, imaging studies are not complete without the corresponding reports, which are traditionally pulled by the RIS. Hospitals are moving towards a patient- and RIS-driven workflow in imaging, and away from an image- and PACS-driven workflow. The RIS is also tasked with the operational aspects of running the department, an area not within the scope of PACS design. These operational tasks have only multiplied and intensified with the introduction of new regulations, quality initiatives, digital technologies, and higher imaging volumes.

All this has resulted in a massive push for healthcare provider organizations to bring their RIS platforms into the 21st century, especially in light of the fact that some existing systems still operate on analog environments. The evaluation orRIS offerings has become among the highest priorities for radiology departments and imaging centers.

EPIC--Radiant is a solid choice for Epic CIS clients. The product is intended for the large inpatient environment, the same market targeted by the EpicCare CIS. The CIS/RIS integration wins high marks from IT administrators, but clinical end users would like to see some workflow adjustments. As the newest clinical vendor RIS offering, Radiant is changing the workflow at Epic client organizations to be more patient- and RIS-centric than image- or PACS-centric.

Siemens--Siemens understands the hospital RIS space. For years, Novius RIS set the standard in functionality and client satisfaction in large hospitals, and now syngo Workflow is building on that success and winning customers in smaller hospitals, too. Clients speak of getting what they pay for with syngo Imaging and syngo Workflow utilized together. The benefits of interfacing or integrating syngo Workflow to Soarian Clinicals and Financials have yet to be validated.

GE--RIS-IC is a capable, user-friendly system that is proven to scale to large organizations. Client satisfaction is better with inpatient customers where more support is handled internally. RIS-IC is becoming more tightly interfaced with the legacy Centricity PACS, but advanced interfaces with Centricity IW are not yet proven.

Cerner--RadNet is able to perform in large, multi-hospital environments as part of the Millennium suite and is also making strides into the community hospital market. It is rarely considered seriously as an option outside the Cerner CIS client base. RadNet's integration with the CIS outweighs almost all alternatives or negatives at Cerner shops.

Meditech--Meditech's RIS module makes sense for Meditech shops. Most Meditech hospitals have fewer than 500 beds, and the RIS module has not scaled to many inpatient sites larger than that. The product wins on integration but lacks radiology-specific functionality, which frustrates department staff. Meditech can be difficult for other vendors to interface with, but most PACS companies in the space have experience working with Meditech clients.

Sunquest--Under the original Sunquest, the Radiology product was the focus of a dedicated support group that delivered world-class service. After the Misys acquisition, support began to deteriorate, and Misys essentially sunset the product just before Sunquest acquired it. The "new" Sunquest declared the product to be a go-forward strategy. Support has not yet reached its former Best in KLAS levels. Sunquest's inability to partner with a PACS vendor, as exhibited by the failed eRad partnership, may prove fatal to this product.
Overall Performance Scores

Additional online.


1               Epic Radiant               84.3
2          Siemens syngo Workflow          79.2
3           GE Centricity RIS-IC           75.6
N/A         RIS (Large) Average            75.6
4         Cerner Millennium RadNet         73.9
5             Meditech C/S ITS             71.3
6            Sunquest Radiology            69.4
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Title Annotation:KLAS REPORTS
Publication:Healthcare Informatics
Date:May 1, 2009
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