In the past few months, artificial intelligence in diagnostic imaging has generated a lot of buzz, much of which includes the word “revolutionary.”  But chances are, AI isn’t on your radar as a practical consideration, and it won’t be for quite a while.  It’s too new, too complex, and for now, out of reach for most practices and even medical centers.  It’ll stay that way until someone figures out how to transform it from an expensive and limited experiment into a useful and affordable everyday tool.

New technologies like AI grab our attention, and we tend to call them revolutionary, but the reality is that they don’t impact patient care until they become accessible beyond research labs and academic institutions.  That’s the interesting thing about technology – the big flashy inventions capture our imagination, but it’s often the tough slog of making those inventions broadly practical that changes the world.

That’s where the real revolution lies.

It’s a universal truth, not just in medicine, but with all technology.  Take the automobile.  The first ones garnered a lot of attention, but it was the Model T, a sparsely featured simple black sedan, that revolutionized society when it rolled off the line in 1908.  Why?  Because it made the technology of the automobile available at a price average folks could afford.  Before Ford’s assembly line changed everything, automobiles had been a curious combination of cutting-edge experiments for mechanical pioneers and dangerous toys for those who could afford them.  Ford’s big achievement was transforming them into a useful everyday tool for families of modest means.

cloud computing iconOne of the biggest revolutions we’ve seen in medical technology in recent years is the move to the cloud.  It hasn’t been flashy, advancing at a sometimes frustratingly glacial pace.  But it has all the hallmarks of the kind of tough-slog revolution that changes the world.  Nowhere is the cloud revolution more obvious than in the imaging workflow, specifically in the growing number of PACS implementations.

When academic institutions in Europe and the US started experimenting with PACS in the 1980s, it was little more than an exciting but impractical idea, a technological curiosity with painfully slow workstations and low-resolution displays.  Nevertheless, it wasn’t long before the private sector recognized the business potential.  By the mid-90s, computing technology had advanced, and so had PACS solutions, with a number of notable enterprise-level offerings entering the market.

The first and most celebrated test case for a large-scale, enterprise-wide PACS implementation started in 1991 at Hammersmith Hospital in West London.  By March 1996, Hammersmith was operating as a totally filmless hospital.  It had taken five years to build the PACS at an astronomical cost, nearly $700,00 in the first year alone.  But it was a success, so much so that within ten years, more than half of the hospitals in the US with 250+ beds had a PACS.

But what about small hospitals and clinics, private practices and imaging centers?  For them, the new technology was a luxury few could afford.  By the early 2000s, multiple vendors were offering an array of PACS options with a growing list of useful features.  But they still came with a heavy up-front investment, substantial on-going maintenance costs, and more IT burden than some hospitals could handle.  A PACS remained tantalizingly out of reach for many providers, who were stuck with CDs and printers, rooms filled with files and films, and time wasted managing it all.

PACS technology would have remained out of reach for most of them if it hadn’t been for one thing, the cloud revolution.  Despite the nebulous name, the cloud is firmly planted on the ground in server farms and data centers.  In practical terms, the cloud is just an off-site computing environment that you access remotely and that someone else manages for you.  It offers far-reaching benefits.

For a PACS implementation, the cloud means no dedicated hardware to buy and replace, no internal IT maintenance, and no data storage headache.  Cost is no longer the daunting barrier it once was.  Since the first cloud-based PACS were introduced, the technology has continued to improve, with vendors spreading the costs of continued feature development across a broad client base.  As a result, some of today’s cloud-based PACS providers offer robust solutions with enterprise-level functionality at a fraction of their previous cost, making them a practical, and increasingly powerful, choice.

Just as Ford’s assembly line put the automobile within reach for the average family, the cloud is putting a PACS within reach of nearly every practice that relies on diagnostic imaging.  That’s a real revolution, one that brings efficiencies for providers and better care for patients.  With apologies to Jimi Hendrix, ‘scuse me while I kiss the sky.  Or in this case, the cloud.  It’s changed everything.

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