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SCAR sessions consider sci-fi inventions that may one day become reality
By: Merlina Trevino and Douglas Page
Total-immersion virtual reality? Robotic red blood cells? Supercomputers with the pattern recognition and commonsense capabilities of a human? With a little help from radiology, some of these science fiction inventions may become reality within the next 50 years.
In the opening session of the SCAR conference, Raymond Kurzweil expounded on the wide-open possibilities of the future. Kurzweil, who invented computer-based speech recognition technology, wrote The Age of Spiritual Machines: When Computers Exceed Human Intelligence and was inducted into the National Inventors Hall of Fame in 2002.
Kurzweil detailed the explosive state of exponential progress in human technology. On every front, from computer transistors to Internet accessibility to medical equipment advances, technology is changing at an ever faster pace.
"Your field figures prominently in the future," he told SCAR attendees.
Addressing the subject of artificial intelligence, Kurzweil said that while the hardware of technology undergoes rapid revolutions in structure every few years, the question of where the software of human intelligence will come from remains unanswered. That is where radiology steps in.
Scientists should be able to provide a template for human intelligence once they can reverse-engineer the workings of the human brain, he said. Using data gathered from imaging technology techniques like functional MR, scientists can begin to understand, and ultimately replicate, the inner workings of the human mind.
Although this reverse-engineering of the brain isn't yet feasible, limited forms of artificial intelligence have already been implemented. As a demonstration, Kurzweil spoke to a virtual reality avatar named Ramona on his Web site (www.kurzweilAI.net). A natural language interface, Ramona responded to Kurzweil's spoken questions naturally and even injected her own brand of simulated humor with an invitation to Kurzweil and the audience: "Why don't you come up and see me sometime?"
With artificial intelligence able to provide better, more realistic speech recognition technology, radiologists soon may not only dictate radiology reports but also translate them into another language simultaneously.
Kurzweil made many bold predictions with aggressive time lines, but he noted that the predictions were not as farfetched as they might seem.
"Evolution is a chaotic process, but its products are remarkably predictable," he said.
Kurzweil wasn't the only one making predictions about the future of radiology at the SCAR meeting. A panel of medical experts peered into medicine's future during a scientific session and saw information systems increasingly taking the lead in efforts to reduce medical errors and improve quality of care.
The panel discussed how leveraging technology solutions can also transform radiologists' procedural role from technology providers to knowledge providers in patient care.
"Radiology has the unique opportunity to lead the efforts to find system-based improvements to the way we work," said Dr. Ramin Khorasani, vice chair of radiology at Brigham and Women's Hospital.
Medicine is in its golden age, thanks to broader access to healthcare than ever before and to providers' ability to noninvasively diagnose most diseases, said cardiologist Dr. Thomas H. Lee, an associate professor of medicine at Harvard Medical School and associate editor of The New England Journal of Medicine. Yet the golden age is killing us, he said.
"My big fear is that the cost agenda will push quality of care out the door," Lee said.
Systems are needed that provide an interface to help physicians exercise their judgment. An example is computerized physician order entry (CPOE). Early adopters already have these tools, but how fast they migrate to majority use is the question and challenge for healthcare, according to Lee.
Healthcare lags behind other industries in adoption of global information systems, he said. A bank card, for instance, recognizes its user no matter where it is used. The same is not true for healthcare.
"These are simple systems that sometimes make gas pumps smarter than the HIS," said Dr. Steven E. Seltzer, chair of radiology at Brigham and Women's.
To become a provider of knowledge, Seltzer said, radiology systems need to facilitate test selection, ordering, and scheduling; test interpretation; results reporting; and distribution of images and information throughout the enterprise.
"The objective is to ensure appropriate utilization of resources, manage costs, improve information transfer, and reduce medical error," he said.
The main benefit of information technology is improved workflow and efficiency, but deployment of sophisticated IT systems should also lead to improved quality and appropriateness.
"If the systems you provide don't relieve overhead and reduce problems for the referring physicians, they won't use them," Seltzer said.
The beauty of information systems such as CPOE is that they do both.
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