Wet Read: Dependence

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“Computers are like Old Testament Gods; lots of rules and no mercy.”

—Joseph Campbell

Radiology is still alive and kicking (for those of you who were there for any of the AI sessions at RSNA, remember that when the machines take over, it won’t be good for ANYONE), but I am more and more aware of our reliance on our machine “colleagues.” Please note I did NOT say “masters.” This has been a slow awakening of awareness for me; I am not that bright. I am, however, observant. Allow me to further expound on this.

We live on the razor’s edge of computer failure. Okay, so, PACS is our tool. It’s our hammer, our pen and paper, our loom, our blank canvas. We used to have acetate film, but now we have pixels on a high-resolution monitor. That data comes from our devices (CT, MR, DSA, US, and even plain film units) via a network, stored on archive devices, and then is displayed for us as we sit at a workstation. We consult the EMR, another bundle of digital connections that originate from someone’s input to the patient record. We generate reports on our transcription system that is, almost universally, functioning without a transcriptionist via voice recognition—you guessed it, another PC.

Here’s my point: we have 100 weak links in the chain! If your voice recognition is down, YOU’RE DOWN. If your PACS is down, YOU’RE DOWN. If your registration system is down, YOU’RE DOWN. You know that feeling of sitting there reviewing images, but being unable to work because you can’t dictate? Or you can dictate, but you can’t see an image? Or you can dictate and see an image, but you can’t get new images because the network is down?

It is an amazing thing that we work at all. It’s reminiscent of the old descriptions of NYC; it is too complicated to possibly work, but there it is. Works most every day. We’ve just installed some new “systems” and the initial downtime was both astounding and frustrating. It’s that sinking feeling of zero productivity. Man, how am I going to explain my RVU output today?

Well, have no fear. When the machines take over, I’m sure they won’t mind too much if we don’t feel much like working for them 24/7. Just returning the courtesy.


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Phillips CD.  Wet Read: Dependence.  Appl Radiol.  2018;47(1):48.

By C. Douglas Phillips, MD, FACR| January 10, 2018
Categories:  Section

About the Author

C. Douglas Phillips, MD, FACR

C. Douglas Phillips, MD, FACR

Dr. Phillips is a Professor of Radiology, Director of Head and Neck Imaging, at Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, NY. He is a member of the Applied Radiology Editorial Advisory Board.

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