OrrMedical imaging professionals continue to push ahead, even as tech sector stocks — especially information technology companies — hit new lows in value.

It’s not as simple as buying and using the state-of-the-art products from IBM, HP or GE. The challenge is to innovate, using technology to create change in a purposeful, focused approach.

Hospitals and radiology departments have been comfortably participating in the medical imaging horsepower race these past few years, buying every new CT, MRI and ultrasound that rolls off the end of the line. This has brought us multi-slice, high field and digital imaging machines that provide better images — and better diagnoses. But there is another world of technology beyond the medical imaging machines that is closely impacting the work of radiologists and physicians. This is the behind-the-scenes technology that impacts infrastructure for the purpose of improved work: bar-coding, scanning, inventory management systems, secure servers, etc.

Did this happen because of an explicit strategy to invest in high-tech systems and software? Not likely. It more likely happened because people with energy and un-common sense were willing to evaluate and adopt technology-based products to change and improve the work of the group. Did you really think that bar-code scanners would just be used in grocery store? Check out Fedex or UPS if you want to see mobile technology at work in these portable inventory units (trucks). PACS started small, and now look how it’s taking over.

Here is a brief review of coming attractions in technology as they relate to the practice of medical imaging, which we all can help keep improving.

We need instant communications and up-to-date information, no matter where or who we are. Pagers and cell-phones were a start, but personal digital assistants (PDAs) are now being nicely combined with wireless network capabilities (802.11b or Wi-Fi technology) to bring instant information to every mobile professional. This is not your grandmother’s Pilot organizer anymore — this is the iPaq on steroids, a full blown worklist, database, network-connected computer “device” capable of providing a physician with an electronic patient record, a prescription pad, a task list, access to research, orders and email. The wireless specification of 802.11b has combined with advances in servers, databases and computing power to make these little devices possible. PDA devices will have just as much impact on the work of technologists and other radiology staff members, too, providing for better information flow among the entire medical imaging team, instantly. In five years, we’ll never remember how we worked or lived without these devices. Do you remember how we worked before email took the place of telephone calls? It was just five years ago too.

On the personal side, this wireless technology is useful at home to easily connect your multiple computers to the Internet. If you have heard enough complaints of kids (or spouses) fighting to use the one computer now hooked up to the Internet, you can be freed from the hassle of running wires in your home with this $250 solution — it’s an out-of-the box strategy and ready to go.

Flat Panel TV
OK, this is technically about flat-panel monitors, but I really want one of these new plasma or LCD TVs at home and soon. As the new commercial for Hummers goes, “It’s not about Need.”

Seriously — OK, stop laughing — flat-panel monitors are invading medical imaging and providing substantially more space for work. Image quality is catching up to the CRT technology that will be displaced, and the digital control of these display units offers the possibility of exact replication of viewed image quality. Will flat panels replace light boxes on the wall and CRTs on the desk? Bet on it. I hear the sound of imploding CRTs all over the medical imaging landscape today. However, the dirty little secret will soon be known — short life cycle. These units aren’t forecasted to last as long as their CRT brothers, so keep some spare budget money on hand for replacements. The technology that made laptop screens bigger and cheaper has arrived on the scene now for home use and medical imaging.

PACS is not a technology, but is really a collection of technologies deployed as a system — first and second generation PACS are already widely deployed. The leading innovators are currently considering moving away from the all-inclusive PAC system (one system for scheduling, archiving and viewing) to a best-of-breed systems management approach. This involves a radical step-up in systems knowledge and design, but offers substantial performance improvements for users. The pieces of this puzzle include optimized network performance (more bandwidth for archiving & routing), local computational power (for 3D, CAD, surgical planning), network licenses for custom software, and customized system design that is facilitated (and not constrained) by vendors. We are now entering the phase where PACS enables more change in the practice of medical imaging than most people have considered. As a result, innovators in radiology are investing a great deal of time and thought in systematically uncovering opportunities for improving the overall practice of delivering a diagnosis in a timely manner that can impact patient care. Attend HIMSS in addition to RSNA — you’ll this all first hand and realize the importance of its scope.

A huge dose of inspiration is the final ingredient to applying this technology — a lack of it will leave you talking about, rather than seizing, the opportunity.

Doug Orr, president of J&M Group (Ridgefield, Conn.), consults with medical device companies in strategy and business development for emerging growth markets, notably radiology and cardiology. Comments and suggestions can be sent to [email protected].