OpenShare Exchange
vs Ambra Health.
Ambra Health, now part of Intelerad, is a cloud PACS, VNA, and image exchange in one: a gateway beside your PACS uploads every study to the Ambra cloud, which stores it and routes it on. OpenShare Exchange links the two sites directly, end-to-end encrypted, PHI on-premise, billed by the gigabyte. Here is how each one works, what it costs, and the other alternatives worth a look.
Ambra Health, explained.
What Ambra is, how a study moves through it, what it costs, and where a direct connection changes the picture.
Through the Ambra Health network
- Your PACSpushes the study
- Ambra Gatewayon your network
- Ambra cloudIntelerad, PACS + VNAcopy stored, billed per study uploaded
- Recipientviewer, EHR, or routed to PACS
The gateway uploads every study to the Ambra cloud, which archives it and routes it on to the receiving site. Ambra’s contract defines a billing event as a study being uploaded.
Direct with OpenShare Exchange
- Your PACSsends the study
- OIE + Exchangeyour site
- OIE + Exchangepartner site
- Partner PACSstudy lands locally
The study travels site to site over one encrypted link. The meter counts gigabytes, and nothing is parked in between.
- What it is
- A cloud-native medical imaging platform: cloud PACS, vendor-neutral archive, and image exchange in one product. Intelerad acquired Ambra in October 2021 for a reported $250 million or more and has consolidated it with lifeIMAGE. Ambra held the #1 KLAS ranking for medical image exchange for eight consecutive years.
- How you get on it
- A facility subscribes and installs the Ambra Gateway on its network. The PACS is configured to push studies to the gateway, RIS orders arrive over HL7, and the gateway uploads to the Ambra cloud, which matches studies to orders and routes them to a destination PACS, a viewer, or an EHR.
- What it costs
- Pricing is custom enterprise and not published. Ambra’s standard SaaS agreement (2019) defines a billing event as a study being uploaded, so the bill follows study count, and the cloud archive is part of the same subscription.
- Where it leads
- Replacing infrastructure. If your goal is to retire an on-premise PACS or VNA and manage images in the cloud, Ambra does that and OpenShare does not. OpenShare Exchange is an exchange layer that works beside the PACS you already run.
Side by side.
Both share medical images between organizations. One hosts the archive and the exchange in its cloud, the other connects the two sites directly and leaves your PACS in place.
Direct exchange layer
OpenShare Exchange is a direct exchange layer built on WebRTC. It sits alongside your existing PACS and OIE integration engine. Data travels directly between organizations, the OpenShare server handles signaling only and never sees your images.
- PHI stays on-premise, never touches OpenShare cloud
- End-to-end encrypted (WebRTC DTLS)
- Flat per-server pricing, no per-image fees
- Works alongside your existing PACS
Cloud PACS + VNA + exchange
A cloud-native image platform from Intelerad: cloud PACS, vendor-neutral archive, and exchange. Every study is uploaded to and stored in the Ambra cloud, with custom enterprise pricing billed per study uploaded.
- #1 KLAS Medical Image Exchange 8 consecutive years
- Cloud PACS + VNA included (not just exchange)
- Clients include Johns Hopkins, Mayo Clinic, NYP (per Ambra marketing)
- Part of Intelerad’s 13,000+ facility network (incl. lifeIMAGE)
Feature-by-feature comparison.
OpenShare Exchange vs Ambra Health (Intelerad). Honest, attributed, with pricing hedged where not publicly disclosed.
| Capability | OpenShare Exchange | Ambra Health (Intelerad) |
|---|---|---|
| Architecture | Org-to-org (WebRTC) | Cloud PACS + VNA + exchange (Intelerad) |
| Data routing | Direct between organizations | Through Intelerad cloud |
| PHI storage | On-premise only | Vendor cloud (Ambra hosts images) |
| Pricing model | $500/server/mo flat + $0.25/GB after 2.5 GB | Custom enterprise, not publicly disclosed |
| End-to-end encryptionAmbra uses TLS in-transit; data stored and accessible on Intelerad cloud | ✓ | ✗ |
| DICOM support | ✓ | ✓ |
| HL7 / FHIR support | Full (via OIE engine) | Limited, imaging platform focus |
| Cloud PACS / VNAAmbra includes cloud PACS hosting; OpenShare is exchange + integration, not PACS | ✗ | ✓ |
| Open source engine | ✓ | ✗ |
| Network scale | Growing (new network) | Part of 13,000+ facility Intelerad network (incl. lifeIMAGE) |
| KLAS recognition | Not yet rated | #1 Medical Image Exchange 8 consecutive years (KLAS) |
| Vendor | Saga IT / open source | Intelerad (acquired Ambra Oct 2021) |
| Free tier | ✓ | ✗ |
An honest comparison.
We believe in direct, truthful comparisons. Here’s where each option leads.
- No copy on a vendor cloud, direct, encrypted org-to-org transfer (we never see the pixels)
- End-to-end encryption (WebRTC DTLS), not just in-transit TLS
- No per-image or per-transaction fees, flat per-server pricing
- HL7 v2, FHIR, DICOM, X12, full data stack, not just imaging
- Open-source engine (OIE, MPL 2.0) with no engine licensing fees
- Free to start, no credit card required
- #1 KLAS Medical Image Exchange for 8 consecutive years, independently validated
- Cloud PACS + VNA: replaces on-prem PACS with cloud-hosted image management
- Proven at major health systems: Johns Hopkins, Mayo Clinic, NYP, Stanford Children’s (per Ambra marketing)
- Part of Intelerad platform with 13,000+ facilities and 80+ billion images managed (combined with lifeIMAGE)
- Consolidated vendor relationship: PACS + exchange from one provider
- Enterprise implementation and support infrastructure
Key distinction: Ambra is a cloud PACS + exchange platform, it replaces on-premises PACS infrastructure with cloud-hosted image management. OpenShare Exchange is an exchange layer that works alongside your existing PACS. These are not fully equivalent alternatives: if your goal is to move PACS to the cloud, Ambra is purpose-built for that. If your goal is to reduce per-image exchange costs and keep PHI on-premise, OpenShare is the better fit.
Frequently asked questions.
Is OpenShare an Ambra Health alternative?
OpenShare Exchange and Ambra Health (now part of Intelerad) address the same core need, sharing medical images between healthcare organizations, but from very different architectural positions. Ambra is a cloud PACS + VNA + image exchange platform: images are stored and managed in Ambra’s cloud. OpenShare Exchange connects organizations directly: data travels between them without cloud intermediary, using end-to-end encryption, with PHI staying on-premise. Ambra leads in cloud image management maturity and KLAS recognition. OpenShare leads in cost structure and data sovereignty.
Who owns Ambra Health?
Ambra Health was acquired by Intelerad in October 2021 for a reported $250M+. It is now part of Intelerad’s consolidated medical imaging platform alongside lifeIMAGE (acquired September 2022). The combined Intelerad platform collectively claims to manage 80+ billion medical images globally.
What is Ambra Health’s KLAS rating?
Ambra Health held the #1 ranking in KLAS Medical Image Exchange for 8 consecutive years, according to KLAS Research. This is a significant independently-validated track record at major health systems including Johns Hopkins, Memorial Hermann, NewYork-Presbyterian, Mayo Clinic, and Stanford Children’s (named on Ambra’s own marketing). OpenShare Exchange has not yet been rated by KLAS.
Does Ambra Health replace PACS?
Ambra Health is a cloud PACS + VNA + image exchange platform, so yes, it can serve as a cloud-hosted PACS archive and VNA alongside its exchange capabilities. OpenShare Exchange is not a PACS replacement; it is a data exchange layer that works alongside your existing PACS and OIE integration engine. If you need cloud PACS hosting, Ambra and OpenShare serve different functions.
What does Intelerad’s acquisition of Ambra and lifeIMAGE mean?
Intelerad acquired Ambra Health (October 2021) and lifeIMAGE (September 2022) to create a combined medical imaging platform. The two products are being consolidated. Collectively they claim 13,000+ facilities, 160,000+ US providers, and 80+ billion images managed. This consolidation may simplify purchasing but also introduces dependency on a single vendor for both image management and exchange.
What are the alternatives to Ambra Health?
For exchange, the hosted alternatives are Nuance PowerShare (Microsoft), which claims about 80% of US hospitals and embeds in Epic, and lifeIMAGE, Ambra’s sister product inside Intelerad, which claims the largest network. For patients who want their own images, PocketHealth offers a consumer-facing service. OpenShare Exchange is the direct alternative for the exchange layer: no hosted copy, end-to-end encryption between the two sites, and a flat per-server membership billed by the gigabyte. It does not replace a PACS or VNA.
