SIIM26’s theme this year was “Building Bridges Across Imaging Informatics”. Here’s what struck me most from sessions, meetings and conversations. Technology components that were once key differentiators — cloud-native architecture, a certain diagnostic AI point solution, or a certain reporting vendor’s tech — are becoming table stakes. So how can this bridge theme apply to what is going on?
Cloud has effectively won; by our estimate four in five or more new enterprise imaging deals in the US are now cloud, and the question has shifted from whether a platform is cloud to whether it was built for one. Cloud-native used to be a selling point — now it’s an expectation.
AI is following the same path: everywhere on the floor, increasingly assumed rather than differentiating. It was pretty clear at SIIM that provider organizations of all kinds are willing to build AI themselves, or partner to build it, rather than getting it off the shelf.
Reporting is a forced decision in the market, the PowerScribe 360 sunset turned a periodic evaluation into an unavoidable choice. At one point the crowd in front of the Microsoft booth was a traffic jam in the aisle. Reporting was also more prevalent, at least to me, in certain vendor marketing. The reporting market looks different than when it was the Nuance and M*Modal show — the expansion of AI in healthcare has brought a wave of new entrants. I recently interviewed a provider exec that saw reporting vendors as basically fungible today.
Many things which were once differentiators in enterprise imaging are becoming table stakes. So what is a differentiator?
Flexibility. The vendors that are standing out are the ones clearest about how they integrate. How open the APIs are. How readily the platform and their tech infrastructure connects to what a provider already runs, and to what they’ll build next, along with even helping them build. In a market where everyone has cloud, everyone has AI, a critical question from the buyer’s side is not what capabilities do you have — it’s how well do you connect to everything else I have.
These are just some of the threads I’m carrying out of Pittsburgh, and it’s what we are testing in upcoming conversations with provider organizations: as these capabilities become table stakes, openness becomes the real basis of competition in enterprise imaging.
A bridge is a connection between two sides where previously they were disparate, or silos. What we know is in healthcare, we don’t want any more silos. A vendor who facilitates openness is creating a bridge. It is that connection bringing things together. So SIIM got it right with the tagline.
If you want to compare notes on where enterprise imaging is genuinely heading, let’s connect. #SIIM2026 #EnterpriseImaging #ImagingInformatics #HealthcareIT
