Now that the dust has settled from the dot-com bust, there is a growing recognition among health care organizations of all sizes that the right IT application can move them forward.

Four years have passed since technology stocks plummeted, signaling the start of the dot-com bust and the beginning of a sobering interlude for American business, including health care. Many of us had to do more with less, and frequently, and ironically, information technology (IT) was pressed into service to help transform us into a worker bee society that some say has surpassed the productivity of the previous world leader in per capita productivity, Japan. Radiologists are no exception. According to ACR data, radiologists are collecting 19% less of billed charges than they did in 1992 (see STAT Read), but overall have not felt the loss because they are working 28% harder.

It is impossible to miss the many signs that information technology is regaining its lost lustre: At this writing, investors eagerly awaited the impending Google initial public offering, and the Wall Street Journal reports that no less than 11 US technology companies have gone public since the beginning of the year; since March 1, 22 more have filed. Also, President Bush released his Health Information Technology Plan ( ), aiming to give every American an electronic health record that can be accessed by every health care provider within 10 years. It comes with a $100 million budget for financing demonstration projects, and a plan for a national health care technology czar.

Aside from the investment opportunities and grand visions suggested by information technology, there is widespread recognition among administrators that IT can solve real-world business problems when properly applied. Nowhere in health care is that more evident than in radiology.

The Radiologist Shortage. When applied in conjunction with strategic work-flow redesign, PACS can help departments maximize the efficiency of their work force by putting images where the radiologists are rather than vice versa.

Charge Capture. New business software that can automatically code procedures is giving providers the ability to capture more of their billed charges (see “The Radiology Reality Show”).

The Slice Overload. With pressure on radiologists to maintain productivity, vendors are engineering more presets for 3D software to enable radiologists to expeditiously review the rapidly increasing amount of information afforded by each study. The virtual colonoscopy protocol described by Perry J. Pickhardt, MD, in his recent study published in the New England Journal of Medicine (see Virtual Colonoscopy: The Road to Implementation) relies on the actual 3D reconstructions and resorts to the 2D images only for verification.

Until now, large health care institutions have led the charge as early adopters, solving many problems along the way, and demonstrating the transformational power of IT. The challenge now will be for small and medium-size hospitals to find a way to equip themselves for this transformation. As radiology departments in hospitals of all sizes outfit themselves for digital capture and communications in radiology, we will continue to provide intelligence and updates on the state-of-the-art in each issue as well as in a special feature several times a year called Decisions in Imaging Informatics beginning in this issue.

Cheryl Proval
[email protected]