Q&A: Implementing technology in stages

Editor's note: Over the past year, Ron Schilling's commentaries in DI SCAN have addressed issues regarding business strategies in medical imaging. We are publishing some of the questions and responses rising from those commentaries, while inviting new requests for information.

Question: Effective implementation of new technology is becoming more challenging. How do we get ahead of the game?

Answer: Dr. Paul Chang addressed this question in an interview in Diagnostic Imaging (Innovations offer radiologists opportunity to remain relevant October 2007). He noted that the availability of advanced visualization on thin clients creates both rewards and risks. The key to maximizing the reward (better services provided by radiology) and minimizing the risk (surgeons and other physicians deciding that they do not need radiological services) is for radiology practitioners to use the technology to provide additional value to their customers. That value can be achieved by adding consultation capabilities, specifically, virtual collaborations.

In an earlier article on the use of strategic thinking tools (DI SCAN, 8/09/06, Successful technology implementation makes medical imaging tick), we discussed how to achieve the maximum value from implementation of new technology. The bottom line was that members of the implementation team must modify their behavior while incorporating new technology to achieve optimal results.

As described by Dr. Chang, new technology is a combination of the server/thin-client model with advanced visualization methods and Web 2.0 for electronic communication. This is to be contrasted with the present technology of independent workstations tied to a PACS.

At RSNA 2007, it was clear that much of this technology is in place and more is on the horizon. The challenge for radiology practitioners is to decide that the only way to achieve virtual collaboration is to adopt new behavior by leveraging the Internet and electronic communication. The old (passive) behavior of using browsers to just consume information is not going to do the job in the future.

By using our 2 x 2 approach, we can provide strategic clarity. Consider these quadrants:

Old Technology/Old Behavior = Workstations (thick clients)/Browser mode of operation

New Technology/Old Behavior = Server/thin-client model/Browser mode of operation

Old Technology/New Behavior = Maximum collaboration with old technology

New Technology/New Behavior = Fully using server/thin-clients to achieve virtual collaboration

Clearly the process to follow is to attain the position of New Technology/New Behavior to achieve virtual collaboration and reap the rewards of the new technology.

How to make this significant change? Avoid the extremely low value and painful condition of New Technology/Old Behavior. Unfortunately, much new technology implementation is paired with old behavior due to a lack of adequate training.

To ensure that we avoid New Technology/Old Behavior, we could decide to go directly to New Technology/New Behavior. This is often a risky approach. If the appropriate training and conditioning (changes in beliefs that drive changes in behavior) do not take place, there is a reasonable likelihood that we will end up in the New Technology/Old Behavior category.

The above suggests that Old Technology/New Behavior might be a good initial step on the road to New Technology/New Behavior. By modifying behavior at the start, one is in an excellent position to reap the full benefit of implementing new technology.

Schilling is an editorial advisor to Diagnostic Imaging and president of RBS Consulting in Los Altos Hills, CA. Comments or questions should be sent to Ron Schilling at Ronald11341@aol.com.