How to Segment the US Healthcare Organization Market for Medical Imaging Visualization Software

Whereas the truism is "know your customer", that may be easier said than done when your innovation is intended to be marketed and sold into Healthcare Organizations (HCO)s. You may have heard the cynical remark from veterans of healthcare IT sales and deployment: if you figured it out for one hospital, you figured it out for one hospital. But do not fear; there are commonalities, patterns and ways to group and segment the enterprise, healthcare landscape.

What follows is how we define market sub-segments of healthcare organizations for a somewhat narrow product class: Medical Imaging Visualization Software. It serves as a good reference point, however, for data-driven software solutions you intend to market towards physician-users. Hopefully, this article can help you strategize and segment the market if you are starting the journey of bringing a software-based, clinical solution to market.

If you spend enough time doing product development for clinical software solutions, you soon realize there is no one, idealized approach to segmenting the healthcare (provider and physician) market. It is highly unlikely you will ever be in a situation in which individual Health Care Professionals will be able to directly purchase your software innovation without the involvement of other stakeholders and gatekeepers. The exception is, of course, "apps" that a HCP can select and run on their BYOD (Bring Your Own Device). Whereas this IS a valid market and monetization path for some, your top-line revenue and scale will be limited. If you want to make and sell a software innovation that has the highest likelihood of impacting clinical management and informing diagnostic and therapeutic decisions, you will most likely need to consider how to bring your innovation to market as an enterprise IT offering. Also, you need to determine if your innovation satisfies the definition of a medical device and how you want to market and promote it.

Considering the previous paragraph and recognizing that there is typically a "buying center" involved in acquiring medical device software innovations, we have found the following definitions and segments to be of value when helping clients find their product-market fit.

We consider a ‘clinic’ to be a location where care is delivered by a mixture of HCPs. These are ambulatory centers and locations that are not intended for high-acuity care. The 6 sub-segments enumerated here are ones that we contend have the highest likelihood to have need and interest in a distributed, imaging visualization solution. Thus, we don’t include dialysis clinic, rehab clinics or mental health clinics as the need for medical image visualization seems unlikely.

Clinics

1.1 Community Health Clinics

These are locations intended to service the primary care needs of disadvantaged populations. Per the KFF (Kaiser Family Foundation), there were 1,342 community health clinics across the US. Funding for the centers come from the US Federal government (HRSA), within CMS. Price sensitivity, ease of use and low complexity would be important factors for this sub-segment.

1.2 Rural Health Clinics

Per CMS, there are ~4,300 rural health clinics across the US serving remote populations. These centers may be staffed by an LPN or PA with assistance from regional health-systems.

1.3 Primary Care Clinics

These are family medicine ‘offices’ or primary care facilities that insured and self-paying patients access. These clinics are independent, owned by a health system/hospital or are for-profit (run by an owner). The need for viewing in this sub-segment are for access to historical patient imagery and reports across modalities (radiology, cardiology, etc.).

1.4 Urgent Care

These are centers intended to alleviate the stress on Emergency Departments but that would address more acute needs than a PCP. These centers are owned/run by health systems, investors, or are independent. Some of these facilities do limited imaging themselves (X-Ray, US) and there will be, because of TEFCA, increasing interest by the clinic staff to access any prior, relevant patient history including diagnostic imaging and reports.

1.5 Retail Clinics

These types of clinics were growing at double-digit rates the past 5 years. They serve as bridge between primary care and acute care. Large, established pharmacy and retail chains (Walgreens, CVS, Walmart) tend to offer these locations as both wellness and lower-acute, urgent care. Like urgent care clinics, there is an argument to be made for allowing these sites access to medical imaging data –especially driven by patient request.

1.6 “One Stop Diagnostic Centers”

These are a very recent phenomenon that may portend a means of also helping to bring ‘integrated diagnostics’ to reality. The concept has been developed and run in Europe and have been piloted in the US by integrated payer-providers (Kaiser) and may have industrial or investor backing (e.g.: GE and St Luke’s). Most of the experiences in this model have been in breast care and the idea is that a woman can get a screening exam, and then quickly have a diagnostic scan, biopsy, and profiling all within one episode of care.

Physician Groups

We break down radiology practices into several categories but cluster other specialists into one item (e.g.: neurology, cardiology, orthopedics). The latter groups are comprised of physician groups –small, large, affiliated, non-affiliated. For radiology practices, we use the following definitions:

Radiology, “Mega” or National

A physician practice group (partner owned or investor owned) that covers multiple states and can have imaging centers. Examples: vRad, Radiology Partners, RadNet

Radiology Group

Regional: radiology practice (hospital owned, partner-owned or investor-owned) that reads for multiple hospitals across a couple states. These groups may have 20-75 radiologists. Examples: SOUTH JERSEY RADIOLOGY ASSOCIATES (SJRA), ILLINOIS RADIOLOGY ASSOCIATES SC

Radiology Group

Small/medium: independent (partner owned) radiology practice that have 5-10 radiologists and may only read for one hospital.

Diagnostic Imaging Center- No Radiology Group

Diagnostic imaging centers that ONLY perform diagnostic imaging and contract with radiology practice groups.

Diagnostic Imaging Center-w/Radiology Group

A practice that does scanning and is also part of or closely affiliated with a radiologist group (on site usually too)

Diagnostic Imaging, Women's Imaging Group (w/rads)

A private practice clinic that only performs diagnostic imaging and some IR procedures on women and that has reading radiologists integrated into the practice.

Hospitals/Health Systems

For Profit Hospital System

This is a ‘chain’ of hospitals, usually across states that run and operate hospitals as a private or public company. Examples: UHS, CHS, HCA

Non-Profit, Integrated Health System

A hospital/physician “integrated” system that may have a payer. The system is not ‘anchored’ by a renowned AMC, though. Examples: Kaiser Permanente, Geisinger, Little Company of Mary Hospital, Advocate Aurora Health-Aurora

Government Hospital

DOD, VA, or public hospitals run by the state or a county.

Independent, Community Health System

A small, health system with 1-10 facilities (maybe only 1 hospital) that could be rural, suburban or urban. Example: St. Clair Health (PA), St. Luke's Health Systems

Non-Profit, Integrated Health System (w/AMC)

The “Meccas” like Mass General Brigham, UC Health, UPMC,

Patient Advocacy/Registries

Non-profit entities that may run registries or research activities in a specific disease area. Examples: Autism Speaks, Rare Disease Network.