From the November 2018 issue of HealthCare Business News magazine

AV or UV integration
For larger institutions, using advanced visualization (AV) software for diagnostic imaging, integration into the AV software is a different way of introducing AI into the radiologist workflow. Although it would make sense from a workflow perspective to have it integrated into the AV viewer used for diagnostic interpretation, this is not yet common. Integrated diagnostic viewing platforms with seamless PACS/AV user interface may be part of the future radiology workflow, but AV today is often used after initial screening on PACS, which means tools for initial triage and screening would currently make more sense to keep on PACS. Most AV vendors today therefore focus on AI tools for automatic segmentation and measurements being used further downstream after the initial screening has taken place.

Universal viewers (UV) have experienced significant uptake in recent years often as a central part of an enterprise imaging solution. With regulatory approval and a growing number of embedded AV tools, these viewers are increasingly being used as a diagnostic viewer, especially in small and midsize hospitals. As AI-based automated diagnosis for routine cases could benefit this segment, many enterprise imaging vendors are indeed looking at integrating AI into the user interface, either through direct integration for best-of-breed solutions or via an online AI marketplace for a selection of tools adaptable to individual clinical specialties.
AI marketplaces
As the number of available algorithms from AI vendors increases, the need for consolidated marketplaces for easier distribution, integration and access grows. EnvoyAI is one such marketplace, providing API-based integration of algorithms and partnering with AV, VNA and PACS vendors for integration. However, several of the major imaging vendors have also started creating their own marketplaces with integration into their user interface. In recent years, the differentiation of vendors into either platform vendors or clinical tool vendors has become more pronounced, and simultaneously, the number of partnerships between the two vendor groups increased to develop the capabilities of existing platforms. A marketplace for AI tools, therefore, fits well with the overall strategy of platform vendors, meaning they can focus less on individual tool development, and more on platform development and integration.

Short to midterm
The solutions being planned and prepared today point toward a mixture of integration strategies remaining in the short to mid-term. This is because each vendor is deciding their integration strategy for AI based on the strengths of their portfolio in each clinical application. For example, an enterprise imaging or PACS vendor with strong functionality, high case volume, and main customer base in cardiology, will typically choose tight integration of cardio AI tools into their platform, but use a marketplace for AI tools outside of cardiology where they have less expertise. Likewise, a PACS vendor with strong breast imaging skills will choose tight integration of breast imaging AI algorithms into their platform, but utilise a marketplace strategy for other applications. In the short- to mid-term, this will create a market where the most common clinical specialities, such as cardiology, breast and pulmonology, will see tight AI integration into diagnostic imaging platforms.

November 2018 Magazine

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