Hyland Acuo VNA Alternatives and How Acuo Compares With Agfa, Fujifilm and Mach7

The short answer: Hyland Acuo VNA is the vendor neutral archive Hyland Software sells with the NilRead viewer and PACSgear capture tools. It came to Hyland in 2017 with the Perceptive Software portfolio, which Lexmark built from Acuo Technologies. Hyland publishes no price, Acuo scored 73.7 to 74.2 in Best in KLAS VNA from 2023 to 2025, and the main alternatives are Agfa, Fujifilm Synapse VNA and Mach7.

This page is for a hospital or health system imaging IT lead with an Acuo VNA renewal, a Hyland cloud proposal or an archive RFP on the desk. Most of what ranks for Acuo today is directory listings and Hyland's own pages, so we put the ownership history, the KLAS record, the federal purchases and the honest list of alternatives in one place.

Ownership facts come from Lexmark SEC filings, Hyland's acquisitions page and trade press. KLAS figures are from the public Best in KLAS ranking pages. Federal figures are from USAspending.gov, award types A to D, fiscal 2008 to 2026, pulled October 6, 2026, with every recipient name and description read by hand.

Who owns Acuo VNA now?

Hyland Software owns it. The product has had three owners in fifteen years, and each change shows up in support contracts and product names, so it is worth knowing the chain before you compare quotes.

You may hear that Hyland is getting out of imaging. We found no announcement of a sale or spin-off on Hyland's acquisitions page or in the trade press, so treat it as a rumor and ask your account team directly. What a buyer should take from the history is simpler: Acuo is one product line inside a company whose main business is OnBase content management, so ask where imaging sits in Hyland's roadmap and how many engineers work on it.

Which Hyland imaging product are you running?

Hyland sells the archive, the viewer and the capture tools separately and together, and the names on your contract may be older than the names on Hyland's website.

How much does Hyland Acuo VNA cost?

Hyland publishes no price for Acuo, and the AWS and Azure marketplace listings are quote only. The checkable numbers are what the US government has paid. We read all 102 federal prime awards to Hyland Software Inc. Most of them are OnBase work for the Air Force, Army, Census Bureau and VA, worth $4.36 million in total. Only a small set is imaging.

No federal award names Acuo, and searches for Acuo Technologies and Perceptive Software return no genuine rows. Federal archives are mostly bought through PACS vendors and integrators, so this record cannot price a full enterprise Acuo deployment. It does tell you how Hyland imaging shows up in practice: modules, gateways and capture tools bought line by line. Expect a commercial quote to be built the same way, with a license or subscription, storage tiers, implementation services and annual maintenance as separate lines.

How does Hyland Acuo score on KLAS?

Acuo has been steady and mid-pack. It has not won the VNA category in any recent year, and the gap to the leader has been 13 to 14 points.

The viewer tells a similar story. In the 2025 universal viewer category NilRead scored 75.4 on limited data from 10 organizations, against 83.5 for Mach7 eUnity and 88.4 for the winner, Agfa XERO. KLAS measures customer satisfaction, not price or technical capability, but a falling number of surveyed organizations, from 27 to 16 in two years, is worth asking about too.

What are the alternatives to Hyland Acuo VNA?

The realistic shortlist depends on whether you are replacing the archive only, or the archive and the PACS together.

An archive migration is one of the most expensive projects in imaging IT, because every prior study has to move and every interface has to be repointed. If Acuo is stable and the complaint is coming from the reading room rather than the data center, replacing it may be the wrong project.

What to ask Hyland before you renew

• The support end date of the Acuo and NilRead versions you run, and of the version the renewal moves you to.
• Storage pricing per terabyte for each tier over five years, using your own study growth, and what happens when you exceed the tier.
• Data export terms: format, cost and timeline to hand every study and every non-DICOM object to another vendor.
• Which services are inside the subscription and which are billed by the hour.
• Where imaging sits in Hyland's roadmap, and what the contract says if the business changes hands.

Write the renewal date, the notice period and the export clause down somewhere that will remind you before the auto-renewal window closes. Plenty of hospitals keep these in a contract management software tool alongside their other vendor agreements, because a missed notice date on an archive contract usually means another full year at the old price.

Can I add AI to the read without replacing Acuo?

Yes. A vendor neutral archive does not stop you adding AI, because the assistant connects to the PACS and the archive over standard DICOM. Radiological.ai receives studies from the PACS or Acuo, flags suspected findings for review, moves urgent studies up the worklist and drafts the structured report. The radiologist reviews, edits and signs every study, and nothing about the archive contract changes.

That makes the AI decision separable from the archive decision. If your radiologists are short on time today, you can fix the read in weeks while the VNA question runs its own course. How the assistant integrates with your PACS explains what connects to what, radiology worklist prioritization shows how urgent studies surface first, and the pricing page lists the per-radiologist plans, from $199 a month billed annually.

For the wider category, vendor neutral archive software for radiology groups explains how a VNA sits beside the PACS, and the zero footprint viewer comparison covers what to check in NilRead or any browser viewer. If the PACS itself is up for replacement, Agfa PACS system alternatives and PACS pricing and cloud PACS cost are the next two reads.