Cloud imaging feels overdue, yet the market keeps revealing a different story. CIOs and imaging leaders are learning that the real friction isn’t fear or lagging tech. It’s clarity. With RSNA25 happening next week in Chicago, this tension feels especially timely as many teams brace for another round of “Are we behind?” conversations.
Enterprise Imaging Adoption Slows as Cloud Strategies Collide
In a recent conversation with Monique Rasband, Vice President of Strategy & Research for Imaging and Oncology at KLAS Research, , she broke down why cloud imaging keeps stalling and what the latest provider feedback reveals about the choices ahead. Her vantage point across hundreds of interviews, including the newly released KLAS Enterprise Imaging 2025 Report, gives her a clear view into the subtle but significant trends shaping the imaging and radiology landscape heading into the RSNA annual meeting.
Key Takeaways
- Cloud adoption is accelerating faster than CIOs think. Many providers who told KLAS they were years away from cloud have already signed or started migrating. Leaders who feel behind are often further ahead than they realize.
- Cloud confusion is the real friction. Providers are now stuck on mismatched cloud strategies across PACS, VNA, and cardiology, creating costly architectural tension.
- The replacement market is at a historic high…because legacy PACS can’t keep up with remote reading, scale, or AI workflows. Even satisfied customers are reevaluating because their incumbent vendors haven’t modernized fast enough for enterprise-scale imaging.
Cloud Adoption for Imaging Is Moving Faster Than It Looks
Many IT teams assume they’re behind on cloud imaging, yet KLAS sees the opposite. Some providers who claimed cloud was “a couple years out” last year have already signed agreements or begun migrating. As Rasband put it, “Some of those last year in 2024 that told me it would be a couple years out for cloud… they have now signed or they’re already migrating data… Organizations that feel like they’re behind, you’re not behind.” It sets up an odd disconnect in the market where things sound like they are moving slowly, but progress is actually happening.
Conflicting Cloud Strategies Create Friction Across PACS, VNA, and Cardiology
Security concerns have faded, but a different problem has taken center stage. Large systems are running PACS on one cloud platform, a VNA on another, and cardiology in a third environment. Even getting aligned on the meaning of “cloud strategy” can derail planning sessions.
Rasband sees this cloudy definition [excuse the pun] often. “Define cloud to me. Tell me what you mean,” challenged Rasband. “If I don’t have an understanding of what they’re talking about, we miss the whole mark. I had someone tell me last week it was a little cloudy, which I liked.”
Imaging teams are operating with similar goals but very different mental models of cloud imaging. This make progress harder than it needs to be.
Legacy PACS Is Cracking Under the Demand for Remote Reading and Enterprise Workflows
The replacement market in imaging is unusually active according to Rasband. The wave isn’t driven by dissatisfaction alone. It is coming from PACS systems that worked well a decade ago but strain under remote reading, enterprise workflows, and early AI use cases.
Rasband sees this pattern across organizations: “Your PACS may be doing really well. But now when you scale it, or if you have a lot of people reading remotely…All of a sudden [that PACS] feels like old technology.” This growing demand is putting pressure on organizations to find solutions rather than wait for incumbent vendors to deliver on their promises.
A Market in Motion Heading into RSNA25
Cloud imaging is no longer a future ambition. It’s moving in uneven steps shaped by mismatched definitions, fragmented infrastructure, and systems pushing past the limits of legacy technology. This interview with Rasband shows that the market is recalibrating around enterprise workflow requirements and remote reading.
With RSNA25 just days away, Rasband has good news for providers: “Organizations that feel like they’re behind, you’re not behind.”
Download the KLAS Enterprise Imaging 2025 Report at https://klasresearch.com/report/enterprise-imaging-2025-as-ei-continues-to-advance-which-vendors-are-improving-customer-experiences/3755
Learn more about KLAS Research at https://klasresearch.com/
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