The Hardware Disruption
I attended my first annual meeting of the RSNA in 2006. I was, to put it mildly, unprepared. I remember being first astonished and then exhausted by its scale. I also remember carrying a cell phone—not a smartphone (and not even a phone with a camera), but just a regular old flip phone, good for nothing but talking and texting. On the exhibition floor, 64-slice CT was big news. PACS developers told me that they had a hard time getting some radiologists to use email, much less their new Web-based tools. At this year’s meeting, I was swapping augmented-reality app recommendations with an old friend from the vendor side of the industry when it hit me how much has changed. There are the obvious changes—we’re onto 320-slice CT, cloud-based advanced visualization, and automated actionable reporting—and then there are the deeper, more disruptive ones. I’ve gone from using a phone with an external antenna to using one that can double as a computer, digital voice recorder, GPS unit, and planner, but I’ve also transitioned to a life in which hardware is meaningless. Imaging is rapidly headed the same way. In no one’s world is a $500 smartphone meaningless, of course. If my phone were irreparably damaged and needed to be replaced, it would be an occasion for a minor meltdown. I have had to replace a damaged phone in the recent past, however, as well as a damaged computer, and aside from the financial penalty, there was absolutely no impact at all. Once I’m logged in on iCloud, my iPhone is the same as any other iPhone in the world; as a piece of hardware, it’s meaningless to me. My desktop is fully virtualized using Dropbox, meaning that the device that I happen to use when I access it is meaningless. At this year’s meeting, I remarked, again and again, on how much the consumer sphere seems to be influencing technology development in health care, from beautifully packaged imaging equipment (as advanced aesthetically as it is clinically) to the use of game controllers to manipulate 3D images. Consumer technology is well funded, fast paced, cutting edge, and—most important—always geared toward usability. Why are so many people entrusting their data to the cloud? It’s easier. To my way of thinking, this is the fundamental disruption that radiology will face over the next few years: finally severing those last, long-standing ties to hardware. Even though hardware has never been better, it is no longer the destination; instead, it’s a portal to the quality, efficiency and value that we’ve all been seeking. Cat Vasko is editor of ImagingBiz.com and associate editor of Radiology Business Journal.