Change Healthcare also has further heavy lifting to do itself to be ready for a rollout; currently it has cited “cloud enablement” of its archiving and analytics modules, creating a solid foundation for further R&D architecture development. However, it is the core imaging diagnostic modules, workflow and advanced visualisation modules that will be the most complex to transition. This is also its highest area of risk; Change has a strong reputation for depth and breadth of offering in core radiology and diagnostic offerings, so expectations will be high. Nucelus.io will also round out the portfolio with image exchange and universal viewing, though it is founded on the Microsoft Azure cloud, whereas Change Healthcare has so far based its cloud offering on Google Cloud; further work will therefore be required to consolidate and integrate the new assets.

Overall, Change Healthcare has been bold in its focus on transition toward cloud-deployment for imaging IT. Based on our ongoing market analysis, we broadly agree that cloud is the long-term direction for imaging informatics in the U.S., with growth in cloud deployment particularly evident in the outpatient imaging sector today, and over a third of imaging IT deals expected to come from hybrid or hosted solutions by 2024.


However, whether the large acute hospital market is quite ready for large-scale cloud adoption remains to be seen; given replacement cycles for imaging IT deals are stretching into ten-year deals and beyond, the likely rate of cloud transition for the market is going to be gradual at best.

For Change Healthcare three questions remain:

- Can a first-mover convince enough existing customers to transition to cloud ahead of the curve to justify the substantial investment?

- How long will it take the firm to provide a fully featured off-premise platform for imaging IT that includes the new Nucleus.io assets?

- Will cloud-deployment for a fully-feature imaging IT solution be enough to win new customers at the cost of its main competitors?

At this stage, it is perhaps too soon to provide a definitive answer, though it is clear Change Healthcare still has some work to do before it is ready for a full-scale, cloud-based platform rollout. But as the Intelerad and Change Healthcare acquisitions both show, cloud adoption for imaging IT is a topic that will be increasingly important.


Steve Holloway is principal analyst and company director for Signify Research, an independent supplier of market intelligence and consultancy to the global healthcare technology industry. Signify's major coverage areas are Healthcare IT, Medical Imaging and Digital Health. Its clients include technology vendors, healthcare providers and payers, management consultants and investors. Signify Research is headquartered in Cranfield, U.K.

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