RIS 2013
The Integration Equation

Worth Knowing

• Does an EMR change always mean choosing the EMR’S RIS? 
  Epic EMR customers using Epic Radiant are pleased. Radiant is the right choice for organizations moving to Epic with the exception of DR Systems PACS users in hospitals under 500 beds. DR Systems’ PACS clients would be well served to consider DR Systems’ RIS, regardless of an EMR change—the single database allows for a single integration point regardless of RIS choice. For customers going with Cerner, there is more gray area. As an integration play, people can make do with Cerner’s RIS, but if available from the incumbent PACS vendor, a RIS/PACS warrants consideration. For smaller hospitals, Novarad is another RIS/PACS option that should be considered.

• Who is vulnerable to replacement? 
  The vendor most vulnerable to RIS replacement from either PACS or EMR changes remains GE, followed by Cerner and Siemens. All three have RIS losses, and providers have sited slow functionality development or a lack of service and support as the causes. Unlike with Epic and MEDITECH, the shortcomings of GE, Cerner, and Siemens are not countered by integration benefits. Despite MEDITECH’s lack of functionality and their customers’ overall dissatisfaction, the MEDITECH RIS does offer integration.

• Where have all the vendors gone?
  Some PACS vendors are struggling in the hospital RIS market. For example, Philips has had little adoption since their 2007 acquisition of XIRIS. Agfa’s RIS has struggled in sales and performance. INFINITT performs extremely well in the small inpatient PACS market, but adoption is low. Standalone RIS vendors Swearingen and Sunquest are both losing market share to integrated solutions. As the entire McKesson platform is transitioning from Horizon to Paragon, it is impacting RIS and EMR adoption, and RIS customers are wondering what will happen with the Horizon RIS. Early adopters of Paragon’s RIS are struggling, specifically with support and implementation. Allscripts’ RIS has not taken off, and its install base remains small.

BOTTOM LINE ON VENDORS

INPATIENT VENDORS

Cerner— Weak overall performer. Ranked second to last. Most Cerner EMR customers opt for Cerner’s RIS, though customers with other RIS vendors are happier. Integration is decent with Cerner’s PACS, but varies widely with other vendors. Phone support neither effective nor responsive. Great scheduling and management reports, but inability to edit data-entry mistakes frustrating for end users.

DR Systems— Should be considered by DR Systems’ PACS customers regardless of EMR. Overall performance improved since 2009; now top-performing solution. Praised for HIS integration; proven to work well with Epic, MEDITECH, and Cerner. User groups result in focused and continual improvement. Customers are loyal. Costs for add-on functionality leave some feeling nickel-and-dimed.

Epic— Overall strong performer. IT department happier than clinical users. Some report Radiant usability improving, especially the mammo module, though improvement not yet reflected in scores. Some clinicians feel ignored. Integration to various PACS is good. No customers looking to leave.

GE Healthcare— RIS-IC integration with EMRs mediocre; PACS integration poor. Improving as a standalone option. Overall performance improved significantly over last two years, but GE lands fourth of seven. Functionality not meeting all needs. Providers report good scheduling, poor reporting. Pace of development better, but not as fast as users would like. New v.10.8 UP2 just released; impact yet to be validated. Most vulnerable of fully rated inpatient RIS vendors.

MEDITECH— Poorest performing inpatient RIS. Functionality basic. Lowest for overall product quality, ease of use, and delivery of new technology. Slow to enhance and develop. Customers are captive—only 41% would buy again yet 97% say it is part of their long-term plans. Clients under 200 beds may benefit from an integrated RIS/PACS over MEDITECH C/S Imaging and Therapeutic Services.

NovaRad— Customers report functionality is similar to that of more expensive systems. Implementations strong and getting stronger. Some want better reporting, but functionality is meeting needs for 75%. No customers looking to leave. NovaRIS would be a strong option for MEDITECH hospitals where MEDITECH RIS struggles. No clients over 500 beds validated by KLAS.

Siemens— Integration with Siemens PACS and syngo.via is passable, but integration to Soarian is weak. Room to improve implementation and training. Upgrades cost too much. Good choice for Soarian sites, particularly when going with a full Siemens imaging chain.

OUTPATIENT VENDORS

Avreo— Right choice for Avreo PACS customers. RIS/PACS integration meeting needs, but scheduling is hit or miss. Customers hitting meaningful use Stage 1, but Avreo team spread thin. Small company feel. Strong implementation and training. Communication and delivery of new technology need improvement.

DR Systems— No reason to look elsewhere for DR Systems PACS customers. Highest-rated overall performance for outpatient solutions; score improved six points over last three years. Praised for meaningful use; great tool for practices. PACS/RIS single database works seamlessly. Highest rated for money’s worth, and 100% said part of long-term plans. Leader in delivery of new technology and overall product quality.

Merge HEALTHCARE— Customers are loyal. Excellent billing. Decent RIS/PACS integration. Several said Merge is a big help with meaningful use but not happy with charges for meaningful use upgrade. Some see improvement in functionality over time; some said new upgrades are buggy.

MedInformatix— Lowest-rated outpatient solution; overall score dropping since 2011. Although customers have achieved meaningful use Stage 1, several looking to move to a new RIS—generally driven to integrated RIS/PACS. Clunky GUI and lowest ease-of-use score. Service and support seriously lacking.

NovaRad— Great choice for NovaPACS users. Seamless integration with NovaPACS. Mixed reviews on functionality; several customers reported excellent scheduling and reporting while others said reports are difficult to obtain. Training needs improvement.