Parting Thoughts: Who is Adapting to Whom?

在过去的20年里，我有幸目睹了我们这个行业的成长和发展。My introduction to the imaging space was assisting in the transformation of a hospital system from film-driven toPACS-driven影像工作流。在过去的二十年里，我见证了PACS解决方案的普及成为我们行业的标准。I’ve also watched asImaging 3.0and deconstructed solutions shift away from vendor-centric solutions to the innovative implementation of new technologies that better achieve the workflow and clinical outcomes that empower radiologists to do their best work.

Over the past several years there has been a growing need to think differently about how our industry addresses the problem statements related to delivering care, relievingradiologist burnoutand addressing the ongoing challenges of reduced reimbursement. A common theme in working with radiology groups of all shapes and sizes across North America is the frustration associated with adapting to the technology environment that supports radiology as a practice.

The Rise of Technology in Medical Imaging

PACS is a solution that has historically been provided by vendors as a self-contained ecosystem. Historically, selecting a PACS vendor was critical because the vendor solution defined the capabilities and the workflow models for all its users. Determining which vendor could provide the best platform for a particular set of problem statements, needs and requirements was critical because of this. The decision to go with a particular vendor was almost always based on the 80/20 rule. If a vendor could accommodate 80 percent of the needs of the organization, users were expected to suffer the 20 percent that made their job more difficult due to the limitations of the given platform. In essence, radiology users were expected to adapt to the software that was selected. And while vendors each had models for user feedback to inform roadmaps, it is common knowledge that those features often would take months, and even years, to be fully realized as a market available option.

The rise of technology likevendor neutral archives(VNA), workflow orchestrators and the philosophical shift toward Imaging 3.0 as well as deconstructed PACS changed the rules of the game. I believe the rise of these technologies was largely driven by the frustration of the technology users having limited control and how their technology was deployed, leveraged and used.

A Noticeable Industry Shift in Radiology

The demands on radiologists have become more complex which has led to the need to have greater control over howtechnologysupports the goals and objectives of the organization. Being able to shape the technology to support the clinical and organizational goals is now essentially a requirement to ensure short- and long-term success. In other words, the industry shifting away from users adapting to the technology toward the technology adapting to the users.

这种转变也带来了一系列挑战。医疗保健It领域缺乏支持复杂技术生态系统的资源，这已经不是什么秘密。我继续接听来自美国各地医院和诊所的电话，寻找能够支持其定制技术环境并理解与成像相关的行业标准(DICOM、HL7、IHE)的合格员工。此外，在他们的客户医院站点内，放射科组织和IT团队之间的IT协作仍然存在持续的挑战。

There also continues to be the challenge of a multi-vendor environment where integration requires elegant and well scripted application programming interfaces (API). And while the industry continues to move toward better integration, it is not uncommon to experience challenges in realizing a seamless user experience in a multi-vendor or deconstructed model.

But the future is bright. Our challenges and frustrations are part of maturing as an industry and driving innovation toward superior outcomes. The work many of us are doing in designing and deploying technology that is shaped by the needs of the user is much more exciting than implementing a PACS. We are being pulled by the adoption of AI and workflow orchestration, and we are being pushed by declining reimbursements and the need to do more with less. These forces will continue to shape how we define ourselves, our practices and who we want to become. And while technology in and of itself is rarely the answer, it is inherently integrated into the solutions we implement that will help us achieve our goals and objectives.

Jef Williams is managing partner for Paragon Consulting Partners, LLC, a Sacramento, Calif., based healthcare IT consulting group. Williams brings more than 25 years in strategic positions in both for-profit and not-for-profit organizations. His expertise lies in leading complex initiatives including large-scale healthcare IT strategy, business case analysis, and solution implementations for both public and private sector clients. Williams speaks regularly and is published on industry issues including operations, management, digital transformation and health IT.