Many vendor neutral archive (VNA) products are evolving to add functionality that enables advanced workflow capabilities on top of storage and disaster recovery. As data becomes increasingly important to healthcare systems, VNA platforms are bringing together disparate patient information silos to form a more complete longitudinal medical record. In advanced platforms that serve as an enterprise service bus (ESB), the VNA is also translating requests for both imaging and unstructured content into the appropriate message types and routing them to the appropriate provider. As such, many VNA vendors believe the term VNA may no longer adequately capture the full range products and services currently available. These new product offerings include communication and workflow tools, universal viewers and an array of maintenance, consulting and implementation service options. For some suppliers with other healthcare IT products, the VNA is also seen as a foundational platform for sales of additional services. In order to meet the demand for a broad service offering many enterprise imaging IT vendors are partnering with other hardware, middleware and software suppliers to ensure they can provide full solution functionality. This is most evident with vendors traditionally focused on providing PACS and RIS systems partnering with multiple independent software vendors (ISVs) in order to fulfil the more extensive needs of their clients.
The market for VNA and image exchange (IE) is estimated at $448 million in 2016, up 15% over 2015. As a share of all other key healthcare IT markets, this places VNA and IE at less than 3%. While this is relatively small compared to other products such as radiology IT, EMR, and business management, enterprise imaging management is still in its early stages of implementation and has significant potential to become a large and profitable sector. Cumulative study volumes for VNA in 2016 are estimated at nearly 3.5 billion, representing a 12.6% share of the global PACS study volume. The cumulative VNA volume is forecast to increase to 7.2 billion during 2021.
The drivers of VNA adoption are linked to macroeconomic factors including healthcare infrastructure implementation, provider consolidation and the long-term goal of integrated care, and connected health. Underlying all of these factors is the need of healthcare providers to decrease dependence on departmental imaging systems while increasing control and ownership over imaging data, in addition to other patient unstructured content. This challenge suits the key characteristics of VNA, providing a clear value proposition for enterprise imaging IT, reflected in the strong growth in installation volumes over the last five years.
Revenue growth in the short and mid-term will mostly occur in North America and Western Europe where a mix of replacement and new demand will be prevalent. Replacement will be spurred by upgrade of early VNA systems and significant increases in scale of installation due to consolidation of hospitals and clinics into larger healthcare networks. New installs will mostly occur in regions where EMR implementation is beginning or is in progress. In the long-term, growth will increasingly be driven by new market creation in countries with developing healthcare systems. IT adoption in healthcare is still lagging for most developing countries, with limited radiology IT adoption and little or no EMR. However, markets such as Brazil, China, Mexico and parts of South East Asia are increasingly investing in healthcare improvement, with healthcare IT infrastructure a key priority.