Tag Archives: Technology

Innovating in a large health system

One would think that resource-rich organizations are able to foster new ideas better than poor, cash-constrained startups.

However, it is remarkably difficult to innovate within a large health system on an ad hoc basis, for the same reason that it is difficult to innovate in a large corporation.  For one, it’s all too easy to feel like a cog in a large machine.  Fear of failure, perceived lack of reward, and a paucity of institutional support are other reasons why innovation stagnates in otherwise resource-rich organizations.

But little-fish-big-pond problems are not the only ones that plague innovation.  This phenomenon is well-recognized as part of the key reasons why disruptive innovations are notoriously difficult to launch from within a corporation.

If you feel this way, you may be an “intrapreneur.”

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Two Questions for Four Data Visualization Types, and Why It Matters

QuoteNot long ago, the ability to create smart data visualizations, or dataviz, was a nice-to-have skill. For the most part, it benefited design- and data-minded managers who made a deliberate decision to invest in acquiring it. That’s changed. Now visual communication is a must-have skill for all managers, because more and more often, it’s the only way to make sense of the work they do.

A June 2016 Harvard Business Review article by Scott Berinato discusses the four types of data visualization, in their traditional “boil complex stuff down to a 2×2 matrix” method no less.  In short, what works depends on the level of details necessary to convey the purpose.

Two axes of data visualization – what works best depends on the purpose

The overall concepts are reminiscent of concepts by Edward Tufte and his many, excellent, books on visualization.

The HBR article is worth a read for anyone interested in business intelligence, data analytics, or data visualization (which, as Berinato says, is probably a misnomer – it’s not the visualization that matters, but the question it seeks to answer).

Towards Healthcare Interoperability: What Must Be Done?

Interoperability is becoming the most sought-after in healthcare, but needs further standardization.  Image Credit: http://cloudpro.co.uk

A few days ago, Walgreens announced a new deal with Epic Systems, joining numerous health systems (and one of its major competitors, CVS) by implementing Epic’s famous electronic health records (EHRs). In its press release, Walgreens cited interoperability as one of the primary reason for this transition:

QuoteThis state-of-the-industry EHR will enable more seamless communication with health systems and local providers, and gives us enhanced capabilities to deliver better health outcomes through greater care coordination and interoperability.”

Interoperability has become the holy grail of technology adaptation in many industries.  Continue reading

Signature

A signature is our handwritten imprint on a document for authenticity.

A signature is also a unique identifier for what is distinctly us, like DNA and fingerprint.

Your work, too, deserves a signature. It deserves a sign of authenticity, and if you are proud of that work, mark it yours. If the quality of the work is not to your par, then don’t put it out.

Just as importantly, the work is itself a signature. Innovation is as much about doing something new as it is doing something you. An easy and sobering way to decide is to first write down all the components of a project onto a list. Then, strike away all the parts that could be accomplished by someone else. Your team will always solve those problems. But if nothing is left, then you have learned that the project doesn’t need you.

That which remains, then, is uniquely you. It’s your value-added. Your signature.

What Is Open-Source? A Guide for The Non-Programmer

This is the first of a series of three discussing open source software for non-programmers interested in informatics. I try to stay as accurate as possible while avoiding jargon.

Open source (OS) has been a popular phrase not only in software engineering but also in radiology. Open source is closely tied to DICOM, the most popular format in medical imaging, in part because many frameworks available to manipulate DICOM files are open source.

OpenSource2

A thorough discussion on OS is available here.  If you are more into an abbreviated 3-minute introduction, stick around.

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Is Radiology Ready for The Cloud?

Taking radiology to the cloud is not a new concept. It has already been discussed here and here, with lowest hanging fruit use-case being cross-institutional image sharing.

The excitement for cloud is certainly abuzz in the non-healthcare market. Several days ago, @TheEconomist tweeted a message ending with “the whole IT business will change.” They were referring to the maturing migration of technology into the cloud.

What caught my eye was not the tweet itself, but the accompanying graphic, illustrated by Satoshi Kambayashi.

From @TheEconomist. Copyright belongs to illustrator

A winged piggy bank with the General Electric logo receives a boot in the loin, eyes wide open with surprise as if he didn’t see it coming at all. General Electric, of course, is one of the biggest vendors in radiology hardware.

So are radiology practices ready to kick GE, too?

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5 Tech Tips Before Starting Radiology Residency

After a well-deserved celebration, the medical students who matched into radiology this year will realize what they’ve known all along – it will be a little more than a full year before they would start the actual residency they signed up for.

In many training programs, this post-match, pre-July-1 time is when the attention starts to focus on the folks who matched last year, those who will be starting in three months. Personally, April was when I also began to both getting psyched about starting a new residency program and getting nervous about preparing.

This post is about buying technology for those who are fixing to start radiology residency this year.

1. Find out If Your Program Has a Computer Fund

Any form of technology is a serious investment for a resident, as a computer can easily cost you a 2-week paycheck.

Before you buy anything, find out if your residency program provides funding for new computer and/or textbooks.

If it does, then great! It is then worth finding out when you can start using it. For instance, my residency program requires that you be officially working – i.e. July 1 – before you are eligible for the professional funding.

2. Get at Least One Portable Computer/Device

A paper in Academic Radiology states that having ready access to technology will become increasingly important in education.

The PACS stations at some hospitals provide unlimited access to the web and are outfitted with modern web browsers and office tools, but others may provide heavily filtered web access with minimal applications. Unless you are certain that your situation is the former, it would be worth having some form of portable computer/device.

Which form factor you decide to go with – tablet, ultrabook, regular notebook, or phablet – is a personal choice. Just keep in mind that the things you might end up using them for:

  1. Take notes during conference
  2. Look up a diagnosis or finding on Radiopaedia.org or one of its commercial competitors
  3. Integrate with electronic medical records – some institution’s EMR would ask that your device meet some security feature requirements
  4. Access the digital edition of a textbook
  5. Touch up a slides presentation for journal club or case conference

3. Get a Twitter Account

Social media is becoming increasingly important in radiology. Any national radiology conference you attend will have a strong Twitter presence, and many people are also on LinkedIn.

Since one of your tasks during the residency is to learn about the most pressing issues in the radiology community at large, becoming familiar with tools like Twitter can be tremendously helpful.

Also, if you start now, you can grab all the cool names before someone else gets them.

4. Avoid EInk Readers for Radiology Books

Radiology textbooks are expensive. It is made worse by the fact that there are so many of them! You will need a book for each subspecialty to really learn the nuances of each rotation.

Unfortunately, eInk readers are just not good enough for images on radiology. Kindle Paperwhite, for example, sports only 16 shades of grey. Reading the same books on a tablet like the iPad, Nexus 9, or Kindle Fire is a different experience, owing to the markedly improved contrast resolution over eInk.

However, be careful that sometimes Kindle or EPUB format books compress images so much that the quality is visibly degraded.

This is not to say electronic books are bad. Buying electronic books can be a good way both to save Benjamins and to reduce the weight of your bag if you load them on a tablet instead of carrying the hardcover incarnations.

EInk readers are great, and I love my Kindle Paperwhite. They are just not for radiology images.

5. Decide If You Want to Pay for an Anatomy Resource

If you are anything like me, you would find memorizing anatomy in a vacuum nearly impossible. Incidentally, it is also one of the most important funds of knowledge to acquire as a first year resident.

Therefore, it is sometimes worthwhile to have access to a good anatomy resource for use on-service. There are free resources like HeadNeckBrainSpine neuroradiology and XRayHead for MSK MRI. e-Anatomy by IMAIOS is an atlas that has some free content but is mostly a paid resource.

At some point you will have to decide whether free resources are sufficient for your needs. Your institution may provide access to a paid resource already, or your professional funding may cover it. If you have to pay out-of-pocket, consider the possibility of sharing an account with a co-resident (make sure you are not violating the user agreement, though).

Conclusion

Radiology residents use more technology than possibly more than other specialty residents from devices, educational resources, to social media. Ultimately how much technology plays a part in your training is a personal preference. However, keeping some of the above points in mind may help you avoid making bad purchase mistakes and be more prepared for July 1.

The Nature of Information Has Changed, and so Should Our Approach

If you are at least 25 years old, you would remember the days when everyone is trying to expedite the speed of information transfer.  Messages began with the courier services, first by horse, then by car.  Then they went digital.  The internet began with dial-up, when 56kbps was deemed state of the art, then broadband.  Then we decided that having to sit in front of a computer to transmit data is too slow.

Back then, when you get a wrong piece of information, it was usually because of timeliness.  Timely data was the business of newspapers, radios, and later television.

At some point, the speed of data transmission became near-instantaneous.

We had thought that faster information means better, but it may come at a cost.  Rapid information is raw, and sometimes inaccurate.  This is a common occurrence, but like car crashes relative to plane crashes, what made Twitter newsworthy is the few times when it nailed the right information seconds after an event, not the hundreds of thousands of times when it misfires.

Like breathing air, bad information has become so commonplace in Twitter and blogs that inaccuracy is invisible to us – we easily process the concept and underlying logic behind why rapid information is sometimes inaccurate, we just don’t think about it often.

And yes, I am aware of the hypocritical nature of using a blog post to divulge this argument.  As it turns out, the burden of verification is on you; I’m just exercising my first amendment rights. 🙂

5 reasons I let Evernote Premium expire

My Evernote Premium service expired this past December.  I decided against renewing the subscription. Evernote is a fantastic free product, but when deciding whether to pay a yearly subscription fee, previously small shortcomings may become deal-breakers.  Continue reading

Can Dr. Watson Practice Medicine?

“Mathematical reasoning may be regarded rather schematically as the exercise of a combination of two facilities, which we may call intuition and ingenuity.” – Alan Turing

Sherlock Holmes is fictional expert in what he calls the “exact science of detection” (A Study in Scarlet). Despite his genius in deductive reasoning and intuition is unparalleled, much of the detective success relies upon the calm and composed guidance of his trusty sidekick Dr. Watson. In most of the canonical novels, Watson acts as the sanity check for Holmes’ storm of ideas and, of course, the meticulous chronicler of their adventures together.

After defeating its human opponents on Jeopardy, the supercomputer Watson by IBM will attempt to learn medicine. Despite its terabytes of storage and raw processing horsepower, Watson’s ability to make medical decisions remains unclear. Can IBM’s Watson truly understand the complex human body and make medical decisions, or will it – like Dr. Watson attempting deduction – prove to be an helpful sounding board but falling short of achieving true intuition?
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