Category Archives: Radiology Innovation and Quality

Disruptive innovation! Six-sigma! DMAIC! Sustainable growth rate!  These are words people throw around, but it’s the idea that counts, not just the acronyms.

The Natural Progression of Radiology as A Business Practice

The terminal destination of all products and services is commoditization.  So that’s a simple answer, though one that’s not all that simple.  The management journal Harvard Business Review dedicates several classic articles on the process of commoditization, including global competition, process modularization, and, simply, the natural resting place of a mature product.

So where does radiology sit in the natural growth process?  More importantly – as junior residents – what have we gotten ourselves into?

Where is radiology in the natural growth progression?

Credit: http://bigideabiology.wikispaces.com/ED+2.C

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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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Robots and Radiologists

In an article titled “The Robot as Radiologist,” Dr. Douglas Green from Univ. of Washington acknowledges the rapid advances in computational image recognition and advent of IBM’s Watson.  He concludes the commentary by taking solace in the fact that, at least for the time being, artificial intelligence is complementary rather than substitutional to human radiologists.  I wholeheartedly agree.  However, Harvard Business Schools gurus do not.

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The Meaning of Version 2.0

drawing

Version 2.0 is a good thing. Except when it’s not.

Being 2.0 means embracing something brand new, something different, revolutionary, totally revamped from the old 1.0 that’s just not as good. It’s simple math, really. 2.0 is twice of 1.0.

The terminology we use for what software developers call a “major version release” is a popular way to address all things new and cool. For instance, in 2010, Justin Bieber released his My World 2.0 album, charming fans world-wide with the #1 hit Baby.

In health care, we also like new versions. Typically used to describe a move towards all-digital access, a post on The Health Care Blog describes the evolving wave of patient self-scheduling methods as “2.0.” An Academic Radiology paper describes radiology education using computing devices over paper as “Radiology Education 2.0.” Even an iTunes app providing a set of emergency radiology teaching cases calls itself Radiology 2.0 (incidentally, because the software is in its first release, the app is actually “Radiology 2.0 v1.0”).

In fact, versioning in health care is so popular that when The American College of Radiology decided to push a new approach to imaging, it decided to skip 2.0 and start with Imaging 3.0.

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Dan Ariely on Conflicts of Interest

On a previously post I became interested in financial conflicts of interest (COI) and disclosure.

COI is not restricted to financial incentives. It also doesn’t have to be a boring topic. Dan Ariely in a TedTalk below discussed perils of COI in academia with compelling anecdotes.

On The NRMP Residency Match, And What People Meant by “It’ll All Work Out”

The optimal solution of the NRMP match algorithm is deceptively simple, but its implication for the lives of applicants is anything but simple.

Three years ago, my then-girlfriend and I sat down and parsed through what would become the most important determinant of our lives moving forward.

Because we attended different medical schools, we carried on a long distance relationship for five years. The NRMP match was more than just a residency choice. It was also a solution that could finally close our distance and take the relationship forward again.

The ranked list seemed like the most difficult decision we had to make. There were so many variables, each with differing levels of importance.

match

Icons made by Freepik from www.flaticon.com is licensed under CC BY 3.0

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Disclosures – on Financial Conflicts of Interest

Conflicts of interest in medicine…

  1. Sometime leads to academic dishonesty
  2. Is pervasive
  3. Is probably unavoidable in the absence of infinite non-profit grants
  4. All of the above

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Measure Differently to Think Differently

Credit: Innovation by Boegh, licensed by Creative Commons

There are many forms of innovations.  Sometimes medical innovation is nanotechnology, molecular imaging, high-precision targeted therapy, or 3D-printed prosthetic, which are advancements whose adaptation rate are limited by the rate of research.  This is a good thing.

And then, there exists technology that has become commonplace in every other industry but is still considered “innovation” in medicine due to their glacial adaptation rates in hospitals and clinics.  Case in point: When was the last time you saw a pager that doesn’t belong to a healthcare provider?

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Do More or Better – But Usually Can’t Do Both

Today’s world provides us with tools that make humans more capable than ever. Writers who used to make elaborate trips to exotic locations to gleam material for the next espionage thriller while talking to their book agent on the landline with expensive long distance fees can now do the research at their computers while setting up an Amazon self-publishing account.  Radiologists who used to be at the mercy of transcriptionists to translate their verbal stutters into fluent medical poetry days later now generate reports within minutes using voice recognition technology.

These are empowering tools, putting the ability to affect outcome directly in the hand of those holding the highest stakes.  In general terms, it makes sense that with advancements in technology, professionals can now (1) do the same amount of work with better quality, or (2) do more work at the same quality.

Unfortunately,  inadvertently what happens is we tend to be expected to accomplish more and do better (occasionally one also expects to feel less tired at the end of it!) Business school professors would teach that technology advances push the entire pareto-efficient frontier forward.  That is, assuming that you are already working at your absolutely most efficient way such that any improvement in speed will automatically have a quality tradeoff, then adapting a new technology may change the nature of the curve such that you can now move both “up” and “to the right.”  The truth is, I am so rarely pareto-efficient in the first place that if a new technology can somehow land me onto my existing frontier, it was well worth the cost.  And while technology like this, this, and this don’t literally breaking any frontiers, they do have the added benefit of putting productivity in my conscious thought and – at least temporarily – make me healthier and more productive.

The Irony of Complexity

Anyone who has worked on a complex problem knows that simplicity is the result of many, many hours of hard work. 

  • Colin Dunno, Designer at Dropbox, in response to the question, “What is the need for all the world class designers at Dropbox, for a product that seemingly has zero complexity?”

Like a figure skater on ice, to score you have to do hard moves but make it look easy.  If the product of your complex work looks complex, then there’s room for improvement.

Healthcare has plenty of room to improve.