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RSNA 2016: to cloud or not to cloud

CHICAGO – Scott Seidelmann, founder and CEO of Candescent Health, a cloud medical imaging service vendor and sort of spin-off of cloud EHR vendor athenahealth, Inc., got off a plane and headed straight to the show floor of RSNA 2016.

It was Tuesday, the second day of the 102nd Scientific Assembly and Annual Meeting of the Radiological Society of North America, held as usual at the vast McCormick Place convention center, the nation’s largest. The event attracted some 52,000 people this year.

This venerable mega-conference both delights radiology and imaging practitioners and vendors because of its all-encompassing range of technologies and ideas and annoys attendees because many must travel the Sunday after Thanksgiving or set up during Thanksgiving week itself.


What struck the Candescent exec most when he stepped onto the show floor was how few cloud PACS (picture archiving and communications systems) and VNA (vendor neutral archives) purveyors have adopted the cloud and its advantages of agility, economy of scale, instant updating and affordability.

“You could walk around this conference for almost any other industry and it’s going to look and feel completely different, whether it’s financials or HR or CRM, everybody’s moved to cloud-based systems,” Seidelmann told me at RSNA 2016.

“They don’t want the servers in their basements, they don’t want the IT people maintaining them, they don’t want the license fees, the service fees,” he said. “Healthcare, more broadly speaking, just hasn’t done that.”

As for radiology, the core medical imaging discipline that Candescent focuses on, Seidelmann acknowledged that its modalities – the advanced machines needed to produce MRI, CT scan, ultrasound, X-ray and other healthcare images – still are hardware devices that have to be kept on premises.

He also recognized that many healthcare providers have moved to hybrid cloud image storage systems, whether PACS or VNAs, with one copy of images stored on-site and backup copies in clouds owned and operated by big cloud service providers such as Dell.

(Dell, by the way, recently split into Dell EMC, a division of Dell Technologies, and Japanese-owned NTT Data Services, which is essentially the old Dell Services, after the old Dell sold its services division for $3 billion and at the same time bought EMC for about $67 billion. Got that? Both new entities were on hand at RSNA 2016).

“Why don’t we move the entire system in that direction?” Seidelmann said, referring to the cloud. “Why don’t we just have a usage-based system that leverages the economies of scale of Amazon or Google or Microsoft Azure that are going to get to unit costs from a storage perspective that are infinitely lower?”

In other words, a way of doing things that is akin to Candescent’s business and technology model.

Seidelmann’s company’s modus operandi is to offer smaller hospitals and radiology clinics a kind of plug-in radiology service that uses the cloud to deliver a SaaS radiology routing and analytics system and complements that with a human-staffed help or traffic control desk.

I should note here that the point Seidelmann argued in the interview with SearchHealthIT jibes pretty well with what a neutral observer of the RSNA 2016 floor might observe, but that many vendors also were offering cloud systems or appearing to be heading toward the cloud.