InfoRAD is dead -- long live informatics

November 28, 2006

When I step onto the RSNA shuttle bus early Sunday morning, two questions dominate my thoughts: Am I out of my mind going to work at this hour on a holiday weekend? What’s the ambiance of RSNA going to be like this year?

When I step onto the RSNA shuttle bus early Sunday morning, two questions dominate my thoughts:

  • Am I out of my mind going to work at this hour on a holiday weekend?

  • What's the ambiance of RSNA going to be like this year?

RSNA 2006 seems very focused. There's no razzle-dazzle. There is lots of applied innovation. Thanks to the availability of the online Virtual Briefcase to facilitate advance review of the several thousand presentations and posters that make up the program, most physicians with whom I have spoken know on arrival what they are going to attend.

The buzz on the shuttle bus does not have the flurry and excitement of debate associated with last-minute selection of two equally compelling presentations.

Those choices are difficult this year. Program content seems to be exceptionally strong. Perhaps that is why the technical exhibition halls seemed downright empty on Sunday. Even Monday, the most frenetic "floor" day, was subdued compared with prior years.

Booths were filled, but I did not encounter any aisle roadblocks caused by milling groups of people drawn like magnets to certain megabooths. Nor did any moderately sized or small booth seem overwhelmed by the RSNA attendees who sniff out extraordinary innovation and pounce upon it in droves. Perhaps it simply was the fact that more people were attending the educational sessions.

InfoRAD is dead. Long live informatics. Two thousand and six marks the year that informatics has come of age as its own specialty.

The Lakeside Learning Center has been radically reconfigured. Instead of a vast hall populated by rows of horizontal lines of posters, there are now two large circles, with rows emanating out as spokes. Each circle is composed of subspecialty wedges. This configuration is theoretically much easier to walk through, but the innermost area does not handle crowding well.

Once again, there is so much content in Lakeside that it is justifiable not to move from the site. While the fun of the multimedia technology deployment demos - the U.S. Army PACS implementations of the mid-1990s, the Radiology Department of the Future, and the mobile women's imaging center telemammography trailer - is a memory of yesteryear, the quality of the individual poster and computer exhibits has become much more professional.

It will be interesting to see if leading-edge technologies of the future will merit whiz-bang displays, such as those that promoted digital conversion of the radiology department. These worked well to draw attention to healthcare informatics innovations. In less than a decade, the future is now.

Teleradiology is resurging. Glen Southworth would have been pleased. The father of commercial teleradiology and telemedicine died this year. Colorado Video, the company he founded in Boulder, started experimenting with slow-scan video to transmit medical images in the early1970s.

Both Colorado Video and its arch rival and only competitor, Robot Research of San Diego, worked hard in 1980 to convince the RSNA meeting committee that teleradiology systems weren't just gimmicks and merited admittance and a 10-foot display.

Dr. Earl Dunn, a radiologist at Sunnybrook Hospital in Toronto, helped establish the first viable teleradiology network in Northwest Ontario. Anchored by Sioux Lookout Hospital and the Hospital for Sick Children in Toronto, the dial-up telephone teleradiology network served as a lifeline to nine remote villages. It provided radiology services where none were available, saved lives, and served as a model.

Readers of Diagnostic Imaging in the 1980s may remember the full-page ads of Dr. Rick, his slate-blue Mercedes, and the shiny silver teleradiology suitcase with a camera on a stick. More radiologists telephoned Colorado Video with offers to purchase the car than to purchase a slow-scan teleradiology system.

Like the founders of so many promising companies that met their demise in this industry, Southworth declined a request by AT&T to build the first video card for use inside a computer. It wasn't that his company couldn't do it. Southworth saw no point in making the investment. The video frame grabbers of Colorado Video had 90% market share; the video quantizers that identified intensity regions and displayed them in artificially sleeted color for x-ray, pathology, and thermal analysis had 100% market dominance; and sales of a newfangled video subtraction system were taking off.

In spite of his engineers' pleas and his management staff's warnings, Southworth said no to the engineers from AT&T, sealing the fate of his company. Those AT&T engineers formed TrueVision. The rest is history.

But Southworth, the Emmy Award-winning visionary inventor, who worked with Carl Sagan to put photographic images on the Pioneer II satellite, would be pleased with the fruition of his vision.

Glen Southworth is dead. Long live teleradiology, the technology he invented.