Abstract
In 2008, the market for PACS was valued at almost $1.3 billion, representing an increase of 6.7% over 2007. This market encompasses large hospitals (500+ beds), medium hospitals (201-499 beds), community hospitals (200 beds and under) and imaging centers (non-affiliated)
TABLE OF CONTENTS
TABLE OF CONTENTS.I
LIST OF FIGURES VII
LIST OF CHARTSX
EXECUTIVE SUMMARY 1
1.1 OVERVIEW OF PACS AND EMR 1
1.2 PICTURE ARCHIVING COMMUNICATION SYSTEM (PACS) . 2
1.3 ELECTRONIC MEDICAL RECORD (EMR) 4
1.4 DIGITAL IMAGING AND COMMUNICATIONS IN MEDICINE (DICOM) PRINTERS 6
1.5 COMPETITIVE ANALYSIS 8
RESEARCH METHODOLOGY 9
2.1 RESEARCH SCOPE 9
2.2 9-STEP METHODOLOGY 9
Step 1: Project Initiation & Team Selection 10
Step 2: Prepare Data Systems and Perform Secondary Research 11
Step 3: Preparation for Interviews & Questionnaire Design . 12
Step 4: Performing Primary Research 13
Step 5: Research Analysis: Establishing Baseline Estimates . 15
Step 6: Market Forecast and Analysis 15
Step 7: Identify Strategic Opportunities 17
Step 8: Final Review and Market Release 18
Step 9: Customer Feedback and Market Monitoring 19
U.S. MARKET FOR PACS, EMR & DICOM PRINTERS 20
3.1 INTRODUCTION 20
3.1.1 Introduction to PACS 20
3.1.2 Introduction to EMR 21
3.1.3 Introduction to DICOM Printers 22
3.1.4 PACS, EMR and DICOM Printer Market Relationships 22
3.2 MARKET OVERVIEW 24
3.2.1 PACS, EMR and DICOM Printer Markets 24
3.2.2 Effect of Economic Crisis . 27
3.3 MARKET ANALYSIS AND FORECAST 28
3.3.1 PACS Market 28
3.3.2 PACS Hardware 30
3.3.3 PACS Software 30
3.3.4 PACS Financing Options 30
3.3.5 EMR Market 33
3.3.6 EMR Hardware 35
3.3.7 EMR Software . 35
3.3.8 EMR Financing Options 36
3.3.9 DICOM Printer Market 36
3.3.10 DICOM Printer Selection 39
3.4 TOTAL MARKET DRIVERS AND LIMITERS 40
3.4.1 Market Drivers for PACS . 40
3.4.2 Market Limiters for PACS 41
3.4.3 Market Drivers for EMR Adoption 42
3.4.4 Market Limiters for EMR Adoption 44
3.4.5 Market Drivers for DICOM Printers 46
3.4.6 Market Limiters for DICOM Printers. 46
3.5 LEGISLATION 48
3.5.1 PACS Legislation 48
3.5.2 EMR Legislation 48
3.5.3 EMR Certification. 51
3.6 COMPETITIVE ANALYSIS 54
3.6.1 Overall Market Competitive Analysis. 54
3.6.2 PACS Market Shares 58
3.6.3 EMR Market Shares 58
3.6.4 DICOM Printer Market Shares 58
3.7 MERGERS AND ACQUISITIONS 59
3.7.1 PACS 59
3.7.2 EMR 59
PICTURE ARCHIVING COMMUNICATION SYSTEM MARKET 60
4.1 INTRODUCTION 60
4.1.1 Definition of PACS 61
4.1.2 DICOM Standards for PACS 61
4.1.3 HL-7 Standards 62
4.1.4 Integrating the Healthcare Enterprise (IHE) 62
4.1.5 PACS Workflow 62
4.1.6 PACS Image Backup 63
4.1.7 Hospital Information Systems and Integration 63
4.2 MARKET OVERVIEW 65
4.2.1 Total PACS Market 65
4.2.2 Market Breakdown 67
4.2.3 PACS Hardware 68
4.2.4 PACS Software 68
4.2.5 PACS Financing Options 69
4.3 MARKET ANALYSIS AND FORECAST 71
4.3.1 Number of Facilities 71
4.3.2 Total PACS System Sales 73
4.3.2.1 PACS Market from New Unit Sales 75
4.3.2.2 PACS System Upgrades Market 78
4.3.3 PACS Service and Maintenance Market 80
4.4 INSTALLED BASE AND PENETRATION OF PACS 82
4.4.1 PACS Penetration . 82
4.4.2 PACS Installed Base 85
4.5 PACS MARKET BY HOSPITAL TYPE 88
4.5.1 Large Hospital PACS Market . 88
4.5.2 Medium Hospital PACS Market 90
4.5.3 Community Hospitals PACS Market 92
4.5.4 Non-Affiliated Imaging Center PACS Market 94
4.6 PACS MARKET BY SPECIALTY 97
4.6.1 Department PACS Systems by Market Share and Unit Share 97
4.6.2 Radiology PACS by Hospital Type 99
4.6.3 Cardiology PACS by Hospital Type . 101
4.6.4 Orthopedic PACS by Hospital Type . 103
4.7 DRIVERS AND LIMITERS . 105
4.7.1 Market Drivers 105
4.7.2 Market Limiters 107
4.8 LEGISLATION 109
4.8.1 Health Insurance Portability and Accountability Act (HIPAA) 109
4.8.2 Integrating the Healthcare Enterprise Standard (IHE) 109
4.9 COMPETITIVE ANALYSIS 110
4.9.1 Leading Competitors in the PACS Market by Market Share 110
4.9.2 Leading Competitors in the PACS Market by Installed Base Share. 114
4.9.3 Competitor Concentration 117
4.10 MERGERS AND ACQUISITIONS 119
ELECTRONIC MEDICAL RECORD MARKET 120
5.1 INTRODUCTION 120
5.1.1 EMR vs. EHR 120
5.1.2 Significance of EMR Adoption 121
5.1.3 Implementation of Computerized Physician Order-Entry (CPOE) 121
5.1.4 HIMSS Analytics EMR Adoption Model. 122
5.2 MARKET OVERVIEW. 123
5.2.1 Total Ambulatory EMR Market 123
5.2.2 Acute vs. Ambulatory EMR 125
5.2.3 EMR Hardware 125
5.2.4 EMR Software 126
5.2.5 EMR Financing Options . 127
5.3 MARKET ANALYSIS AND FORECAST 128
5.3.1 Total Revenue from Sales and Annual Support 128
5.3.2 Total Number of Ambulatory Practices 130
5.3.3 Installed Base and Penetration of EMR 132
5.3.3.1 EMR Installed Base 132
5.3.4 EMR Penetration 135
5.3.5 EMR Units Sold 137
5.3.6 EMR Average Selling Price of Per-Practice Model . 139
5.3.7 EMR Average Selling Price of Subscription Model 141
5.4 QUANTITATIVE BENEFITS AFTER EMR IMPLEMENTATION 143
5.4.1 Reductions in Chart Pulls, Transcription Costs, Number of Patient Encounters and
Malpractice Premiums. 143
5.4.2 Reduction in Storage Space and Management of Archives 145
5.4.3 Total Cost Savings after Year One of EMR Implementation 147
5.4.4 Time Frame: Point of Purchase to EMR Installation 149
5.5 INFORMATION TECHNOLOGY AND EMR FUNCTIONALITIES 150
5.5.1 Physician Preference for Mode of IT Support 150
5.5.2 Physician Preference for EMR Model and Operating System 152
5.5.3 Preferred Functionalities by Physician Practices for EMR Package 155
5.6 MARKET DRIVERS AND LIMITERS 157
5.6.1 Market Drivers 157
5.6.2 Market Limiters 159
5.7 EMR LEGISLATION AND CERTIFICATION 164
5.7.1 EMR Legislation . 164
5.7.2 EMR Certification 166
5.8 EMR COMPETITIVE ANALYSIS 169
5.8.1 Leading Competitors in the EMR Market by Market Share . 169
5.8.2 Competitor Concentration 172
5.9 MERGERS AND ACQUISITIONS 174
DIGITAL IMAGING & COMMUNICATIONS IN MEDICINE PRINTERS 175
6.1 INTRODUCTION 175
6.2 MARKET ANALYSIS AND FORECAST 177
6.2.1 DICOM Printer Market 177
6.2.2 DICOM Printer Units Sold 179
6.2.3 DICOM Printer Selection 181
6.3 DRIVERS AND LIMITERS . 181
6.3.1 Market Drivers 181
6.3.2 Market Limiters 182
6.4 COMPETITIVE ANALYSIS 183
6.4.1 Market Share. 183
6.4.2 Installed Base Share . 187
6.4.3 Competitor Concentration 189
ABBREVIATIONS 192
LIST OF FIGURES
EXECUTIVE SUMMARY 1
RESEARCH METHODOLOGY 9
U.S. MARKET FOR PACS, EMR & DICOM PRINTERS 20
Figure 3-1: Total PACS, EMR and DICOM Printer Markets, U.S., 2005-2015 25
Figure 3-2: Total PACS Market, U.S., 2005-2015 28
Figure 3-3: Total Ambulatory EMR Market, U.S., 2008 33
Figure 3-4: Total Market for DICOM Printers, U.S., 2005-2015 37
Figure 3-5: PACS, EMR and DICOM Printer Markets Drivers and Limiters, U.S.,
2008 47
Figure 3-6: Leading Competitors for PACS, EMR and DICOM Printer Market
Shares, U.S., 2008 56
PICTURE ARCHIVING COMMUNICATION SYSTEM MARKET 60
Figure 4-1: Total PACS Market, U.S., 2005-2015 65
Figure 4-2: Number of Facilities, U.S., 2005-2015 . 72
Figure 4-3: Percentage of Revenue from PACS Sales, U.S., 2005-2015. 73
Figure 4-4: PACS Market from New Unit Sales, U.S., 2005-2015 76
Figure 4-5: Percentage of Revenue from System Upgrades, U.S., 2005-2015 78
Figure 4-6: Percentage of Revenue from Service and Maintenance, U.S., 2005-2015 80
Figure 4-7: Penetration of PACS, U.S., 2005-2015 . 82
Figure 4-8: Number of Facilities with PACS, U.S., 2008 . 84
Figure 4-9: Installed Base for PACS, U.S., 2005-2015 86
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LIST OF CHART S
