Successful technology implementation makes medical imaging tick

August 9, 2006
Ronald B. Schilling, PhD

The successful implementation of new technology is what makes the field of medical imaging tick. Making this happen cost-effectively is often difficult to do, because we are dealing not only with the technology in question, but also with the processes associated with implementation. These processes affect behavior and behavior is driven by one’s belief system.

The successful implementation of new technology is what makes the field of medical imaging tick. Making this happen cost-effectively is often difficult to do, because we are dealing not only with the technology in question, but also with the processes associated with implementation. These processes affect behavior and behavior is driven by one's belief system.

One approach to analyzing this situation is to consider a strategic thinking tool to provide clarity. For the analysis of new technology adoption, we will use a tool known as the 2 x 2 table. The 2 x 2 table considers two major directions but breaks the situation into four parts.

We are dealing with new and old technology as well as new and old processes. These provide us with the four categories shown in the table. Consider the arrow shown in the upper-right to represent the direction of increasing productivity.

The lower-left box is characterized by old technology and old process. Besides being boring, this situation will ultimately lead to declining sales, since the world we live in is changing so rapidly. No one can stand still in the field of medical imaging for long.

Let's turn to the upper-left box, which is characterized by new technology and old process. This is a significant box, as it represents the typical history of the medical imaging business. New technology is purchased by the user without any meaningful change in the processes associated with the technology. In other words, no evidence is provided to change users' beliefs and, therefore, their behavior remains the same.

The result is extremely low value in that an expensive new technology is underutilized. The cause of this situation is often a lack of training in the use and merits of the new technology. Such training would go a long way toward changing beliefs and, hence, behavior. In the field of PACS, the first five years were characterized by this situation. This negative start held the market back for several additional years before the growth period could get under way.

The lower-right box is characterized by old technology and new process. "Moderate value" is used to describe the significance of this position. This is because focusing on achieving the best process for a given technology leads to the very best result achievable with that technology. This box is an excellent example of changing beliefs and behavior.

Clearly the best place to be is in the upper-right box characterized by new technology and new process. This box represents the best conditions for increasing productivity. Since this is the best place to be, we must consider the best way of getting to this box when starting from the lower left.

We have three choices in proceeding from the lower-left to the upper-right. It's a no-brainer to eliminate going to the upper-right via the upper-left since we should avoid "low value" at all costs. This leaves two alternatives. If the world were a perfect place, we might consider going directly from the lower-left to the upper-right. However, the world isn't always perfect and we must avoid sliding into the upper-left box. This leaves us taking the path to the upper-right via the lower-right box.

We could consider that this means achieving moderate value in advance of getting to the best place. Alternatively, we could view this approach as training prior to the installation of new technology. That is, fully understanding all of the requirements for optimizing productivity and being fully prepared at the time the new technology is installed. The result is a jump-start for the new process that is essential to achieving the very best results. As noted above, this is an excellent example of changing beliefs and behavior.

The bottom line is that the team (doctors, administrators, technologists, etc.) must focus on a given area of new technology and consider how to ensure ending up in the best place to be. In addition, this is an opportunity for vendors to work with the team to provide the guidance required to achieve the ultimate goal.

Mr. Schilling is an editorial advisor to Diagnostic Imaging and president of RBS Consulting in Los Altos Hills, CA. Comments can be addressed to ronald11341@aol.com.