Thursday, October 28, 2010

Market Consolidation? Where?

As I look around and more and more companies in the PACS marketplace are being bought, sold, and merged. “For once” I thought to myself “the market is rightsizing”… If I am to believe the RSNA 2010 Exhibitors List I was never so wrong in my life…

I went to the RSNA web site a week ago to get a list of exhibitors in different areas for a Webinar I am doing in early November titled “How to Make the Most of Your RSNA 2010 PACS Review”. The areas I looked at were PACS, PACS Components, RIS, CD/DR, Voice/Speech Recognition and Archiving. As I looked the numbers I saw were astonishing so I went back and compared them with the same vendor numbers I had from 2006. The result was even more astonishing.

The number of vendors showing PACS Components rose from 165 to 212, a 28.5% increase, Companies showing PACS rose from 136 in 2006 to 201 in 2010, a 48% increase. Archiving rose from 97 vendors in 2006 to 192 in 2010, a 98% increase. Companies showing Radiology Information Systems went from 109 in 2006 to 235 in 2010, a 116% increase. CR/DR vendors went from 79 to 270, an incredible 242% increase while Voice and Speech recognition went from 48 vendors in 2006 to 227 in 2010, a whopping 373% increase. Now only about a quarter of these listings can be considered real with the balance either cross listings or duplicates, but the same statement held true back in 2006 as well. This made me ask just what the heck is going on in this marketplace. The answer is simple. Everyone wants to get rich and they feel medical imaging offers that pathway. It doesn’t as the 500 of so vendors who have come and gone in the time I’ve been in this marketplace have realized but please don’t tell that to the plethora of vendors entering into the marketplace today. They might actually get smart.

We have come a long way in the nearly 30 years since I entered the PACS arena in 1981 helping to develop and sell a teleradiology system called the DigiPAC 8 (for 8 bits) that offered blinding 19.2 Kb/second transmission speeds (vs industry standard 9600 bps) and a highly evolved camera on a stick,. Our biggest competition back then came from Colorado Video, Dataspan and Raytel, names that unless you’ve been in this industry for a long time you probably never heard of. I doubt you also heard of the company I worked at the time for called Image Resources (IR) either. They too have come and gone. IR has a great product that could have owned the marketplace but we simply ran out of money before we could ramp up. The total budget for product development (software coding), marketing (including show budgets like RSNA), hardware and s software, my salary, and the rest was a whopping $50,000.00 (yes, there is a decimal point after the 5th set of zeros) and we simply ran out of bucks after 18 months (back then I made just slightly less than I make now too). Money got so tight that when we went to pay for dinner one night at RSNA the company credit card was declined. If you have never had to deal with this before (it was a fairly high class place where dinners were about $40 per person back then) the maitre de comes to the table and called me away saying “Excuse me sir we have a phone call for you (pronounced more like ewwwww by him)” Keep I mind this was 1981 and we didn’t have cell phones then. In fact it wasn’t until a few years later that I got my first cell phone- the Motorola DynaTAC 8000 more affectionately know as “The Brick” that Michael Douglas used in the movie Wall Street (and yes I still have it too). I follow the maitre de to the back by the kitchen and he says “We are sorry sir but you credit card has been DECLINED.” We’re like WTF!!! And had it not been for a few spare Am Ex travelers checks I always carried on me we would have been seriously fucked too as that was pre-ATM days when you could actually play the float…OK, now where was I?

There are lots and lots of companies who will be coming to RSNA in another month seeking fame and fortune. About a quarter will fail, but if history repeats itself twice as many will rush in to take their spot. David Hannum, the man who headed the five man syndicate who paid $30,000.00 for the Cardiff Giant back in 1869 summed it up best- "There's a sucker born every minute.". And no it wasn't P.T. Barnum either who said it. Hannum turned down an offer from P.T. Barnum to buy HIS giant fake fossilized man so Barnum created his own fake and well….. The tale is intriguing for sure. If you want to learn more click on this

The takeaway from all this is things aren’t always as they seem, someone is always ready to take your spot, and everyone seems to be willing to invest in what seems like a sure thing…..but most times really isn’t. Should be an interesting show this year for sure.

Monday, October 4, 2010


Every day I take our ADHD poster child of a dog Elvis, the Wonder beagle, out for his morning walk where he blesses each and every living (and many dead) things with his own personal brand of baptismal water. One of the places that has received his daily blessings over the years has been this dead and decaying log. Cut down well over a decade ago judging by its look I never paid it much attention until recently. Somehow, somewhere deep inside the heart of stump a sapling took root and decided to grow. Over the past 6 months I have watched in amazement as it grew taller and taller each day, gathering strength from the old stump and showing the stump that it still had value. Each time I see it I cheer on its progress and smile, thinking about what my mom used to tell me growing it “It’s not how many times you fall down, it’s how many times you get back up.” And so, too, it goes here. Left to decay and rot, this stump refuses to be a victim and instead chose to sustain and support new growth giving the ultimate victory salute to those who chose cut it down in its prime with three simple words- “I will survive”.