Value-based Imaging: A Model For Future Innovation

What something does is more important than what it is. This is common knowledge in consumer electronics.

Seventeen years ago, Steve Jobs sold the iPod — not on the product specs of a 5 GB hard drive measuring 1.8-inches — an impressive engineering feat in its own right — but with the claim that it put “1,000 songs in your pocket.” Instead of leading with what the iPod was, Jobs told prospective buyers what it would do for them. He used the specs to support his claim.

iPod的宣传可以追溯到2001年。但这种方法并不新鲜。我曾半开玩笑地把创新描述为“自切片面包以来最好的东西”，一个起源于1910年代早期的cliché网站。但是切片面包并没有立即受到欢迎。几十年过去了，直到20世纪30年代，在Wonder Bread的几次宣传中，这种面包才开始流行起来。Wonder Bread出售的面包不仅是切片面包，而且还“以8种方式塑造强壮的身体”。”

Yet, so disruptive was sliced bread that today it is hard to find packaged bread that is not sliced.

Imaging’s Opportunism

Historically the makers of imaging equipment have been content to focus on their products. During thecomputed tomography (CT)slice wars, vendors upped the “slice” ante every 12 or 18 months. It started with 4 slices; took an interim step to 8; went to 16; took another interim step to 32; then rose to 64, which remarkably is now the high end of low-tier CT scanning.

What was the significance of each successive generation? Certainly not productivity. If presented in the context of throughput, the several seconds saved from one CT generation to the next hardly mattered, considering that techs spend minutes prepping patients. Similarly, reduced cooling times for X-ray tubes — specs worthy of note for the engineering that went into them — meant little in themselves.

但是更快的扫描时间和更快的试管冷却使得在繁忙的急诊室可以进行更多的全身扫描。他们可以一起将病人从分诊转到治疗，并最终提高病人的满意度、安全性、方便性和舒适度——甚至可能是结果。但这些指标很难记录下来。供应商们发现，围绕工程技术实力的宣传更容易。

The same was true for scanners delivering 512 or more slices per rotation. They eliminated motion artifacts when imaging the heart and made brain scans more exact. But what effect did they have on the patient? Could a scan done with one of these CTs increase the chance that Dad would come home after a stroke in much the same condition he was before the stroke or heart attack? I didn’t hear that argument when new, top-flight systems were unveiled. What I heard were the engineering specs.

For sliced bread to take hold, it had to be part of something bigger, something that connected with buyers; something that promised to make them … healthier. A major selling point for CT scanners was (and is) how they affect patients.

Style and Substance

这并不是说风格胜于实质;不是关于牛排的咝咝声。这是关于说顾客的语言;产生共鸣与需求;与市场保持联系。

供应商偶尔也会认同这种想法，但这只是临时的。它当然不是产品开发背后的推动力。以开放式磁共振成像(MRI)为例。20世纪90年代中期，磁共振扫描仪的制造商一直在苦苦挣扎，直到开放式中场扫描仪开始流行。是病人推动中场进入主流。

Recognizing that high-field scanning contributed substantially to high-quality imaging, vendors launched major efforts to develop high-field opens. Then they realized that scanners didn’t have to be open, just roomy. Given the difficulty and expense of creating open scanners that operate at truly high fields, the short, wide-bore scanner was born.

Vendors began talking up the comfort benefits for the patient and the “footprint” advantages of these scanners. The less space required, the easier the siting — and the more floor space for other uses. Today every major MR vendor offers short-, wide-bore scanners; all allude to the more spacious experience for patients.

In short, paying attention to what the product can do for the customer (and the patient is the ultimate customer) versus what a technology does can make a huge difference. This is what value-based imaging is all about. And it is what makes value-based imaging the ideal foundation for product models.

Value-based imaging focuses on efficiency, cost-effectiveness and patient satisfaction. Developing products that improve the practice of radiology in these ways could be the cornerstone of a business model, one that spurs the development of needed products rather than rationalizes ones that are already developed.

Opportunism has been the de facto marketing model for original equipment manufacturers. OEMs have tended to develop and make what their engineers have shown was possible, then wrapped those developments in what the market demanded.Iterative reconstruction (IR)is an example. First positioned as a way to improve CT image quality, IR was later — and to this day continues to be — marketed as a way to reduce radiation dosage while maintaining image quality.

Shifting To Value

Like miners following veins of gold serendipitously found, OEMs mine technological veins created by their engineers. Why not implement business models to create what providers and patients need?

创造这种“双赢”的局面不仅会改变公司的行为方式，还会改变公司本身。反过来，成为未来的正确公司将推动正确的行动。这种思维产生的商业模式将提供基础。这些基于客户需求的模型将创造出一条长长的跑道，让创意得以落地。

Value-based imaging is made to order for this. It is intended to deliver value to the patient and, consequently, to the provider. Moreover, it provides a framework in which OEMs can plan for the future; radiology can evolve, and health care can improve.