OpenShare Exchange
vs lifeIMAGE.
lifeIMAGE, now part of Intelerad, claims the world’s largest medical image exchange network: studies upload through a local appliance to its cloud, partners pull them from an inbox, and the meter counts transactions. 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.
lifeIMAGE, explained.
What the lifeIMAGE network is, how a study moves through it, what it costs, and where a direct connection changes the picture.
Through the lifeIMAGE network
- Your PACSsends the study
- LILA applianceon your network
- lifeIMAGE cloudInteleradcopy kept, billed per transaction
- Recipientinbox, viewer, or their PACS
Studies upload through the local appliance to the lifeIMAGE cloud, appear in the recipient’s inbox, and are nominated into their PACS. The meter counts transactions.
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 vendor-agnostic exchange network for medical images and supporting evidence such as reports and documents, acquired by Intelerad in September 2022. lifeIMAGE claims 13,000+ facilities, 160,000+ US providers, and 13 million clinical encounters a month, and together with Ambra Health more than 80 billion images under Intelerad management.
- How you get on it
- A facility subscribes and installs LILA, the lifeIMAGE Local Appliance, on its own servers beside the PACS. Sending sites upload to a drop box; the study lands in the receiving site’s inbox, where a PACS administrator nominates it into the local archive with the record numbers reconciled. Physicians can also view through the web and mobile apps.
- What it costs
- Intelerad does not publish lifeIMAGE pricing. Contracts are per transaction or custom enterprise terms; the company’s founder once described the model as “$1 per exam” (2011). Because the meter counts transactions, the bill grows with your volume.
- Where it leads
- Reach. If the facilities you exchange with are already on the network, lifeIMAGE connects you to them without any joint deployment, and it carries reports and documents alongside DICOM. That breadth is its strongest argument, and a direct exchange only wins where both sites are willing to run it.
Side by side.
Both move medical images between organizations. One routes them through a hosted network, the other connects the two sites directly.
Direct org-to-org
OpenShare Exchange uses WebRTC to establish direct encrypted connections between healthcare organizations. Data travels between Org A and Org B directly, OpenShare never touches the images. WebRTC DTLS encryption protects the data end-to-end. Billing is by bandwidth, never by study count.
- PHI stays on-premise, never routed through vendor infrastructure
- End-to-end encrypted (WebRTC DTLS)
- Flat per-server pricing, no per-transaction fees
- Works with existing PACS + OIE engine
Centralized exchange network
A hosted exchange network from Intelerad. Studies upload through the local appliance to the lifeIMAGE cloud and partners pull them from there, with per-transaction or custom enterprise pricing. “World’s largest medical image exchange network” is lifeIMAGE’s own claim.
- 13,000+ facilities (lifeIMAGE claim)
- 160,000+ US providers connected (lifeIMAGE claim)
- 13M clinical encounters/month (lifeIMAGE claim)
- Combined with Ambra: 80+ billion images managed (Intelerad claim)
Feature-by-feature comparison.
OpenShare Exchange vs lifeIMAGE (Intelerad). Competitor claims attributed and hedged where appropriate.
| Capability | OpenShare Exchange | lifeIMAGE (Intelerad) |
|---|---|---|
| Architecture | Direct org-to-org (WebRTC) | Centralized network (Intelerad cloud) |
| Data routing | Direct between organizations | Through Intelerad / lifeIMAGE network |
| PHI storage | On-premise only | Vendor cloud / network |
| Pricing model | $500/server/mo flat + $0.25/GB after 2.5 GB | Per-transaction / custom enterprise |
| End-to-end encryptionlifeIMAGE uses TLS in-transit; data routed through Intelerad infrastructure | ✓ | ✗ |
| DICOM support | ✓ | ✓ |
| HL7 / FHIR support | Full (via OIE engine) | Yes, vendor-agnostic claim includes clinical evidence |
| Open source engine | ✓ | ✗ |
| Network scale | Growing (new network) | 13,000+ facilities, 160,000+ US providers (lifeIMAGE claim) |
| KLAS recognition | Not yet rated | Intelerad platform rated; lifeIMAGE pre-acquisition was rated |
| Vendor | Saga IT / open source | Intelerad (acquired lifeIMAGE Sept 2022) |
| Cost scales with volumelifeIMAGE per-transaction costs increase with study volume | ✗ | ✓ |
| 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
- Flat per-server pricing, cost does not scale with study volume
- HL7 v2, FHIR, DICOM, X12, full data stack via OIE engine, not just imaging
- Open-source engine (OIE, MPL 2.0) with no engine licensing fees
- Free to start, no credit card required
- Established network: 13,000+ facilities, 160,000+ US providers (lifeIMAGE claim), OpenShare is a new network
- 58,000+ global clinics and 13M clinical encounters/month (lifeIMAGE claim)
- Self-described as “world’s largest medical image exchange network”, their marketing claim
- Part of Intelerad platform: consolidated with Ambra for 80+ billion images managed
- Vendor-agnostic design: connects organizations regardless of their PACS or EHR vendor
- Established enterprise support and implementation infrastructure
Network vs economics: lifeIMAGE’s primary value is its large existing network, if your trading partners are already on lifeIMAGE, the switching cost is meaningful. OpenShare Exchange is most compelling for organizations whose partners are willing to deploy it jointly, where the per-transaction cost savings and on-premise data control outweigh the network breadth advantage. For high-volume sites, flat pricing can be significantly cheaper at scale.
Frequently asked questions.
Is OpenShare a lifeIMAGE alternative?
OpenShare Exchange and lifeIMAGE (now part of Intelerad) both enable medical image and clinical data exchange between healthcare organizations. lifeIMAGE claims to be the world’s largest medical image exchange network, connecting 13,000+ facilities and 160,000+ US providers. OpenShare Exchange connects organizations directly: data travels straight between them without routing through a centralized cloud, with end-to-end encryption and flat per-server pricing. lifeIMAGE leads in network breadth and established integrations. OpenShare leads in cost structure and data sovereignty.
What is lifeIMAGE?
lifeIMAGE is a vendor-agnostic medical image and evidence exchange network. It claims to connect 13,000+ healthcare facilities, 160,000+ US providers, 58,000+ global clinics, and to process 13 million clinical encounters per month. lifeIMAGE was acquired by Intelerad in September 2022 and is being consolidated with Ambra Health (acquired October 2021) into a combined Intelerad imaging platform.
Who owns lifeIMAGE?
lifeIMAGE was acquired by Intelerad in September 2022. It operates alongside Ambra Health within the Intelerad platform. Combined, Intelerad claims to manage 80+ billion medical images across 13,000+ facilities globally. “World’s largest medical image exchange network” is lifeIMAGE’s own marketing claim.
How does per-transaction pricing compare for high-volume exchange?
Per-transaction pricing models (used by centralized exchange networks) scale linearly with study count, the more studies you send, the more you pay. OpenShare Exchange bills bandwidth instead: a flat $500 per-server/month membership with 2.5 GB of transfer included, then a published $0.25 per GB. Cost tracks gigabytes, never study counts, so high-volume sites stay predictable. The breakeven point depends on your volume and negotiated rates with lifeIMAGE/Intelerad.
Can OpenShare connect to existing lifeIMAGE / Intelerad facilities?
OpenShare Exchange uses standard DICOM and HL7/FHIR protocols via the OIE integration engine. Interoperability with lifeIMAGE’s network depends on the protocols and interfaces lifeIMAGE exposes. For direct exchange, both organizations need to run OpenShare Exchange. For connectivity to the broader lifeIMAGE network, integration via standard DICOM DIMSE or DICOMweb may be possible through OIE.
What are the alternatives to lifeIMAGE?
The established alternatives are the other hosted networks: Nuance PowerShare (Microsoft), which claims about 80% of US hospitals and embeds in Epic, and Ambra Health, lifeIMAGE’s sister product inside Intelerad, which adds a cloud PACS and VNA. For patients who want their own images, PocketHealth offers a consumer-facing service. OpenShare Exchange is the direct alternative: no hosted copy, end-to-end encryption between the two sites, and a flat per-server membership billed by the gigabyte instead of per transaction.
