SIIM: Is innovation the path to better, cheaper PACS?

DALLAS—With most, if not all, PACS suffering from a potentially fatal case of “feature-itis,” imaging informatics is in dire need of innovation. Bradley J. Erickson, MD, PhD, department of radiology at Mayo Clinic in Rochester, Minn., offered a roadmap for translating innovation to clinical practice during the opening general session of the Society for Imaging Informatics in Medicine (SIIM) annual meeting.

Although the journey from bench to bedside is riddled with roadblocks and innovation and translational research are fundamentally competitive, organizations can create an atmosphere that supports “coopitition” (a blend of competition and cooperation), according to Erickson.  

Supporting synergy starts with understanding the nature of innovation and translational research and creating an environment conducive to both.

Innovation, explained Erickson, entails a complex and fundamentally disruptive life cycle characterized by breaking the rules. In contrast, translational research applies lab-proven processes to the clinic. It applies the rules.

Innovation is risky, said Erickson. It can disrupt, and possibly destroy a business. To help the audience understand the risks, Erickson detailed the four P’s of innovation.

• Principle—Contrary to conventional wisdom, innovation does not originate with a single eureka moment. Typically the main idea takes months or years to develop, and represents the collision of many ideas or concepts from many people.
• Prototyping—Each iteration has to capture the key idea but not necessarily reflect a perfect replica of final product. Critical at this stage, said Erickson, is enticing test users to verbalize what they did and did not like about the product … and listening to their feedback.
• Production—This stage may entail some loss of control for the innovator, who often may not have the business acumen required to finalize the translation from concept to market. An expert can help confirm the idea, create the business plan and launch the product.
• People—The most important component is people, who must recognize that innovation is a challenge that demands disrupting the plans and products of others. Innovation, said Erickson, requires a culture that incubates cross-pollination and risk.

Erickson explored innovation in PACS terms, contending that most PACS and RIS, despite the plethora of bells and whistles, are not fundamentally different from the systems of 10 years ago. “Innovation is not about saying yes to everything. It is about saying no to all but most crucial ideas. We need to rethink how PACS is done and how to simplify so it works better. It may be cheaper to build a better PACS.”

He concluded with some advice for organizations and suggested:

• Rewarding staff who disrupt in a constructive way;
• Partnering with vendors to identify opportunities to innovate; and
• Developing a resource base, including financial support, to test ideas.