Nathalie McCaughley, MA, MBA is president of Agfa HealthCare.
Tell me about yourself and the company.
I have 25 years in healthcare IT leadership roles, including 20 years with GE Healthcare globally. I have been with Agfa HealthCare for five years. I am French American and have been in the US for 23 years.
From a professional standpoint, I have held positions globally across pretty much all functions. I would describe myself as a growth leader who is focused on growing a business strategically, leading to tangible outcomes and a high potential to scale. Taking over businesses that are in need of new strategy and a new takeoff, which is exactly what happened with Agfa HealthCare.
Agfa HealthCare is part of a broader group, Agfa-Gevaert. Our division is in a very different industry than the rest of the group. I was asked to take over the business in 2021, with the full mandate of the board and the group CEO to reshape the company and reposition it for growth, from both a financial and customer recognition standpoint.
How has enterprise imaging changed in the past five or 10 years, and what are its strongest areas of growth?
The healthcare industry has gone through a pretty intense era of consolidation among hospitals and outpatient centers. Over the past five or six years, we have seen an emergence of high-scale, very large health systems.
Everybody knows PACS, and enterprise imaging is often confused with PACS. PACS is a vertical, departmental-only solution. Enterprise imaging spans the entire health system across all “ologies.” When you connect this with the era of consolidation, where you have hospitals that are now health systems that are 10, 20, even 30 times the size, it becomes impossible to manage 30 different systems across the health system. The need arose to have a single, central platform to manage all imaging needs, such as storage and acquisition. That is enterprise imaging.
We come as a single solution, sitting over all of those individual PACS and managing the imaging health records for patients the same way an EMR is managing electronic medical records. We work alongside the EMR. That’s how enterprise imaging emerged from a needs standpoint. The consolidation and the scale of health systems is not slowing down due to financial and demographic reasons.
We anticipate, driven pretty clearly by those external factors, that enterprise imaging is not only here to stay, but will be the way that we work moving forward. That was the opportunity to bring a solution with strong relevance to healthcare and customer needs, plus an extensive runway to answer critical current and future challenges.
With that consolidation, how have expectations changed for being able to read images from any location on consumer-grade devices?
The bigger change in expectation is that you used to look at technology vendors. In the past, even our own company was selling an IT solution and software. This is no longer the case. We established and committed to being end user driven and clinician-first as a decision framework that guides our product design, cloud strategy, AI integration, and service delivery.
Technology is not meant to add complexity. It is not meant to be added work for a clinician. It is meant to make their life easier. Enterprise imaging adapts to the clinician and doesn’t force them to adapt to the technology. A true clinician-driven technology that is created for the clinician protects the clinical focus and confidence rather than competing with it. Everything has to be clinically driven, make an impact, make things easier, increase diagnostic accuracy, increase speed to diagnosis, and eventually serve patients. In the past, technology was separated from those priorities.
When a health system acquires a hospital, do they usually try to replace an existing system with a corporate standard?
They do it when they can. That is definitely a next step. Coexistence might be done at the beginning, but in the long term, it is not manageable and it is very costly. We have health systems that have more than 300 locations, which means that if everybody has their own system, they have as many IT teams, data server rooms, and so on. This is not sustainable from a management, security, and cost standpoint moving forward. Eventually, consolidation is required.
You are seeing it with Epic in the EMR world. We attach to Epic very well, but the number one startup discussion that we have with our customers is that they have 15 hospitals and 15 different paths. That doesn’t work, and they cannot afford this any more. Enterprise imaging comes in with standardization that creates efficiency not only financially, but from a productivity standpoint by simplifying processes. Backing the clinician first and improving workflows to benefit patient diagnostic and the speed to it.
How far along is the move to cloud and what possibilities does it offer?
I would refer again to demographic, financial, and operational factors. We talked about the consolidation of hospitals. Financial margin erosion is among the top three challenges for health systems. They see their margin eroding and they can no longer sustain what they were doing in the past, meaning acquiring an on-premise solution and maintaining a farm of servers in their back yard. The upfront investment was so substantial that it is no longer part of what they can do financially. They are challenged to do things better.
This has probably triggered not only cloud deployment, but also a subscription-based type of business with those health systems. Health systems are accelerating cloud adoption for a number of reasons, such as resilience, scalability, speed, and cost efficiency. We are focusing our strategy on being able to offer successful enterprise-wide cloud transformation with the right governance, security, and operational discipline.
How will you incorporate AI into your products?
AI is a big part of what we do. Workflow-embedded AI is critically important. We believe that it supports decision making without increasing the cognitive burden. AI is fully part of our solution, but fully embedded, not creating an additional click, an additional screen, or an additional platform.
This is how we see the growth of AI in enterprise imaging, as a fully embedded solution. The role of AI, at least in our space, is to enhance consistency, efficiency, and diagnostic confidence while keeping the clinician in control. The question we often hear is, will AI replace radiologists? No. This is not what we are doing. We are making things better. We are making them more productive, more accurate, and eliminating waste of effort, but keeping clinician in control.
AI will not replace radiologists. Radiologists will be replaced by radiologists who use AI. A health system may have 300 radiologists, and among that population, we’re seeing some that are resisting it and some that are embracing it. The future is made up of radiologists leveraging or using AI, not the other way.
What are the important elements in the company’s strategy over the next few years?
We have been focusing on the clinician first, so security has become a big part of our innovation strategy. Enterprise imaging, in its native role, sits at the intersection of clinical care, data governance, and cybersecurity. A strong security and compliance framework enables innovation, cloud adoption, and AI integration in full confidence for our customers.
When you adopt a software solution, the number one thing that you have to acquire from your customers is trust. We establish trust as a prerequisite for the long-term partnership with these health systems and healthcare organizations. It is foundational. As we’ve seen in the news, a cybersecurity event can bring down an entire ecosystem.
Our ability to develop the right partnership, being fully embedded in our customers’ strategy, is important. When you engage in a cloud transformation for enterprise imaging, for instance, this is not a one- or two-year journey. This is a long-term marriage. Developing those partnerships on the right foundation is critical.
We have seen the need for enterprise imaging and we are committed to it. What is truly unique about enterprise imaging is that compared to some other areas of healthcare, we are not a commodity. This is an existing need, a growing need. We are fully invested in rapidly increasing our clinical relevance as a solution for our health systems.
Is the "E" in EMR/EHR electronic or enterprise? Electronic seems dated, like horseless carriage.