The Changing Future of Innovation

Innovation is all around, especially at trade shows. It’s been that way for as long as I can remember. What’s different today is that the type of innovation has changed. This change is especially evident in information technology, whereartificial intelligence (AI)and cloud computing are driving markets.

The use of AI to interpret radiological images was emphasized at the annual meeting of theHealthcare Information and Management Systems Society (HIMSS)in Orlando. The presence of AI was obvious in theInnovation Live Pavillion, just as its presence was palpable on the exhibit floor. Ditto for cloud computing, which like AI, rated its own forum at the HIMSS meeting.

Innovation Teems At HIMSS

Trade shows are rife with innovation. That was the case at HIMSS 2019, as it was atRSNA 2018, where vendors showed products and works-in-progress for every marketable form of imaging modality and information technology. I am certain we’ll see other such offerings as the year progresses, each tailored to specific medical disciplines and applications, at annual meetings for the American College of Cardiology (ACC) in March;Society of Breast Imaging (SBI)in April;Society for Imaging Informatics in Medicine (SIIM)5月;andAmerican Society for Radiation Oncology (ASTRO)9月。

Driving the need to innovate is the newfound patient centrism ofvalue-based medicine, which is creating demands that medicine is finding hard to fulfill. Underlying it all — masquerading, if you will, as technological insight — is fear … fear of not meeting patient expectations.

在这个快速发展的创新世界里，激进的思想每时每刻都在转变成传统的思想。它是人工智能和云计算种子生根发芽的沃土;两者都预示着经济和临床的进步。但人工智能和云计算只是新型创新的例子。

Vendors are focusing on the ends that their products provide rather than the means by which they are obtained. CT vendors, for example, years ago stopped focusing on the number of slices their scanners produce in a single rotation; how fast the “gantries” — actually the electronic guts within — scan a patient; or even how fast a scan is performed (unless, of course, the CT is targeting the emergency department). Now vendors are focusing on clinical or operational benefits for patients or users. In short, the means are blending into the background.

This is why the adoption and use of AI and cloud computing are happening out of sight and out of mind from patients — and providers — who care mostly about results. It is why AI and cloud computing are being adopted and will continue to be adopted in the foreseeable future — and not because they are the latest or most advanced technologies.

This is a decidedly good thing. It is how it must be if the price of healthcare is to be checked (or go down) at the same time quality goes up. These two are different sides of the patient centrism coin. And both — clinical and operational improvements — must be achieved if value-based medicine is to really catch on.

Technological transparency is the “go-to” characteristic as the world becomes more and more dependent on the results of technology. In this world, AI and cloud computing are the “doers” that will allow providers to reach what were previously unattainable goals.

Why Profits Matter

选择不仅决定我们做什么，还决定我们是谁。设备供应商根据供应商的需求做出了选择。一般来说，这些选择都反映了可以用绝对确定性衡量的东西。例如，从连续的几代系统中每次旋转可以得到更多的CT切片。这个指标很方便，直到薄片的数量明显没有放射意义。类似地，供应商指出扫描速度，通常以十分之一秒来衡量，奇怪的是，这种速度在减少病人等待时间或积压方面几乎没有意义。

Departments that purchased these systems based their decisions on metrics that have since become either obsolete or are rapidly doing so. This has or is happening thanks to a fundamental change among healthcare providers. Simply put, the profit motive is taking hold.

Profits have long been important to equipment vendors. And for good reason. Generating more revenue than expenses has been essential for companies to grow or — even more basically — stay in business. But this reality of the business world had largely eluded healthcare providers if they purchased new equipment releases that achieved only iterative improvement, particularly when the improvement had no calculable impact on either their bottom lines or patients.

Theslice warsin CT — where quad-slice scanners gave way to 16-, then 64- and 128-slice models (with stepping-stone releases of systems capable of generating, for example, 8 and 32 slices) — exemplify this. The war stopped only after it was obvious that the majority of patients would not benefit — when 64-slice scanners delivered as many slices per rotation as radiologists could reasonably use.

In that vein, profits, it seemed, were once widely viewed as antithetical to healthcare. They were the oil; patient care was the water. Totally incompatible. But the realization has begun to set in that volunteers who wheel patients out of hospitals and fund-raisers that help pay for equipment can go only so far. Neither is sustainable. Smart management is.

Economics — the common denominator of business success — is becoming a part of healthcare. And it is being made so by value-based medicine — and value-based imaging.

How Value-based Imaging Is Powering AI, Cloud Computing

创新是这个价值方程式的一部分，它与过去被定义为创新的东西有着根本的不同。技术不再是王者，而是王者的创造者。它在临床上为病人的健康带来益处，在手术中为医生的底线提供支撑，这些都是看不见的。虽然技术一度被供应商视为一个(有时是关键的)差异化因素，但人工智能和云计算往往是透明的。它们本身并不是重点。他们的研究结果。

人工智能和云计算是催化剂。它们使基于价值的改变成为可能。这就是为什么人工智能和云计算正在——并将继续——占据主导地位。

Rather than being iterative, innovation now has a loftier purpose. It is focused on making healthcare higher quality and less expensive — and they promise in some circumstances to do both at the same time. Value-based imaging requires that diagnosis be not only precise but that patient wait times are shorter; care must be rendered efficiently to multiple interested parties, as well as the patient. And the most successful applications are ones that not only do these but also make a difference in the clinical management of the patient.

This is heady stuff. But not so much that they are beyond the reach of today’s innovation. And that is the beauty of what we have now. It’s a lot different than how it used to be.

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