In the new health care paradigm, as in life, everyone wants everything yesterday. Nonetheless, the urgency of the Information Age is disconcerting for those of us who grew up when people regularly used the phrase, “Let’s sleep on it.” Today, it seems, no one is ever here or there, but always on their way. Everything is needed at once and nothing can wait until tomorrow. It is all email, overnight courier, facsimile machines, and telephones. Snail mail has become a delaying tactic. When was the last time anyone used a stamp for anything other than to mail a payment to a creditor or the Internal Revenue Service? Stan Davis and Chris Meyer have named this phenomenon in their book, Blur: The Speed of Change in the Connected Economy. It is a fascinating take on the new economy for which the authors present a radically different set of rules to live by. More on the subject can be found at

It is in this context that radiology is currently refashioning itself from an esoteric consulting service to command central of the health care continuum. Radiology is no longer in the picture business, it is in the information business, and communication is a critical aspect of this transformation. To assist radiologists and administrators to navigate this new terrain, we introduce this month Decisions in Imaging Informatics, a special issue of Decisions in Axis Imaging News. We will publish Imaging Informatics quarterly in 2001.

Beyond this page are articles on voice recognition software and its impact on processes and work habits; building and using a data warehouse for optimal image access; an award-winning prototype for structured reporting; a facility that uses a new standard for inserting images into the electronic medical record; and Web-based image distribution. In reviewing all of these articles, it becomes clear that there is not one way to wire your department for optimum communications. There are many.

We are grateful to the authors and interview subjects who have shared within the pages of this first edition of Imaging Informatics their experiences and experiments in the effort to streamline and facilitate the flow of radiological information. Their work is the beacon by which others will follow, the scaffolding upon which can be built everything from outcomes analyses to improved technology assessment.

Meanwhile, there is no turning back the hands of the clock to the time before blur. The job of radiology is not just to view and interpret images, but also to communicate the findings to the appropriate interested parties. Where quality and accuracy are equal, the deciding factor in the fate of a practice or department will be how well that information is communicated.

Some of you will persist in stopping to ask whether the world is a better place with our heightened connectivity. Will wiring health care really result in the improvement of the delivery of health care in our society? While we consider that, we must also answer these questions: Back when radiology closed up shop at the end of the day and the world did wait until morning, what did hospitals do with their critically ill patients? How did emergency departments handle trauma and stroke patients?

Cheryl Proval

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