A few months on from ECR in Vienna, I've had time to sit with what I actually took away from a busy stretch of events. First, there was ECR in the spring. Then our CTO, Rob Walker, and I attended Rewired in my hometown of Birmingham. Now as the team prepares for HIMSS Europe in Copenhagen, I find myself considering my event takeaways far and what that means for me at HIMSS 26.
This is partly a reflection on the event season. But mostly it's about one question that I keep coming back to, no matter what beautiful city I’m in: why does data availability remain the hardest part of an increasingly sophisticated ecosystem?
Heading into the European Congress of Radiology in Vienna is always a bit of a reality check. The scale of innovation is hard to ignore. MRI systems, AI-driven imaging tools, workflow platforms, all packed into one place. Loud, busy, and very easy to fall into the trap of just moving from meeting to meeting without stepping back to ask what's actually changing underneath all the conversations.
I went in with a specific hypothesis to test: the imaging ecosystem is exploding with new tools, but we're still underestimating the "glue" required to make it all work in the real world.
So instead of general networking, I focused my time on understanding what the last mile of imaging data actually looks like in practice. I had over 30 conversations across AI diagnostics, workflow platforms, 3D post-processing, and larger enterprise imaging vendors. Across all of them, one theme kept surfacing.
Innovation is scaling. The ability to operationalize it isn't keeping up.
The most striking conversations were with AI and imaging-adjacent vendors. What I was trying to understand seemed quite simple.
When their applications depend on cross-regional imaging and report data, whose job is it to actually make that data available, standardised, and usable?
That question hit a nerve every time.
In most cases, data availability is still treated as the hospital's responsibility. Vendors build increasingly advanced applications, but rely on healthcare providers to identify where the data is and create the integrations needed to feed those tools. In practice, that means every new solution introduces another set of point-to-point connections.
Hospitals don't have the bandwidth to build and maintain dozens of these. Vendors aren't in a position to own that layer across every deployment. So you end up with a shared dependency that nobody fully owns.
That's the gap. And it's not a technology problem as much as a structural one.
The conversations with enterprise imaging vendors surfaced something related but distinct.
These organizations are highly optimized for clinical workflows. They run the systems hospitals depend on day to day, and they're excellent at it. But the environment around them is shifting fast.
We're moving from relatively contained hospital environments to cross-regional and national networks. In Europe, that shift is being driven by national programs and regulatory change, such as; image availability initiatives in the Netherlands via the DUO framework, KHZG mandates in Germany, and the European Health Data Space shaping how data is expected to move across borders.
For enterprise imaging vendors, this creates a real scaling challenge. Supporting different regional requirements often means building and maintaining multiple interoperability approaches, whether XDS, FHIR, or something else depending on the market. That adds engineering overhead. It slows delivery. And more importantly, it pulls focus away from what these vendors are actually trying to do: improving clinical workflows and imaging capabilities.
A few weeks later, I was at Digital Health Rewired in Birmingham with our CTO Rob Walker.
The context was different. Rewired is very much shaped by the NHS environment, where progress depends on how well existing systems, local relationships, and partner-led delivery models are connected and operationalized due to a lack of funding for new innovation or value-led solutions. But the underlying question was identical.
In the UK, the path to data availability runs through a different set of constraints: integrated care structures, legacy infrastructure, and the reality that meaningful progress happens through partners already embedded in those environments. What Rewired made clear is that there's no shortage of ambition. What remains hard is operationalizing it consistently at scale.
Two different ecosystems. Two different conversations. Same friction point.
The pattern that emerges across ECR, Rewired, and the broader conversations I've had this year is consistent.
The issue isn't a lack of innovation from vendors. There's no shortage of new tools, platforms, or capabilities in this space.
The issue is how all of it connects.
Right now, much of the ecosystem still runs on point-to-point integrations with hardcoded or proprietary connections. Each one is built separately. Each new application adds more complexity. That approach doesn't scale anymore.
What the market needs, and what is slowly becoming more widely acknowledged, is a shift in how we think about interoperability. Not as a series of individual integrations, but as a shared, foundational layer. A layer that handles data availability in a standards-based, scalable way, so that:
That separation creates cleaner accountability. And it makes scaling across organizations and regions realistic rather than theoretical.
HIMSS Europe always feels like the moment where these conversations find a different kind of gravity. The room is pan-European, the regulatory backdrop is live, and the same questions I've been hearing all year get asked in front of people who are actively deciding what to build next.
What I've found myself thinking about, heading into Copenhagen, is what success actually looks like at an event like this. For us, it's not about volume of conversations. It's about depth. Are we talking to the right people? Are we making the structural argument clearly enough? Are we helping partners and providers connect what they're experiencing on the ground with what's actually possible?
This year, the team will be at Booth C3-109 from 19-21 May. If any of the themes above are familiar to you, I'd encourage you to come and see what we're building. We'll be showing a live demo in the Interoperability Showcase, which puts the data availability argument in its most concrete form. And our Chief Product Officer Zvi Kleiner will be on the Tech Leadership Stage on Wednesday 21 May at 16:00, speaking to the structural shift from point-to-point integrations to infrastructure-level data availability, and what that means for vendors, providers, and networks trying to scale.
The one most important thread from this event season worth carrying forward, is that the current model of building and maintaining individual integrations is no longer sustainable for anyone in the ecosystem.
AI vendors hit this when they try to scale beyond early adopters. Healthcare providers feel it in the operational burden on their IT teams. Enterprise imaging vendors run into it as they expand into new markets with different requirements.
Different perspectives. Same underlying issue.
The shift toward shared, standards-based data availability infrastructure isn't a distant aspiration. It's already happening in pockets across Europe, and the conversations in Copenhagen will make clear how far the market has come.
If this resonates, I'd genuinely enjoy continuing the conversation in person. Find us at Booth C3-109, come and hear Zvi on the Tech Leadership Stage on Wednesday 21 May at 16:00, or reach out if you're attending and want to explore how this translates into real projects.