EDITORIAL The march of technology in the radiology workplace: Are we getting trampled?

I am now officially old enough to be nostalgic. As a resident, fellow, and junior faculty member, I was content to sit at the view boxes, put up my films, dictate into a tape recorder, and place the films back in the patient’s film jacket; possibly the correct jacket. I answered one telephone on the wall. I had a beeper with no text. True, roughly 20% of “my” films never made it to me to be interpreted. Previous films were available in the film folder about 70% of the time. The transcriptionist occasionally invented new words and “rhabdomyosarcoma” once became, “rather mild sarcoma.” Another time “the patient was prepped and raped in the usual fashion.” The final reports typically got to the chart in 3 to 5 days.

When this year’s incoming fellows and residents arrived for the new academic year, it really hit home to me just how radically things have changed in our department. We are now an “early adopter” department. It struck me as a daunting task for the incoming folks to quickly learn to use a vast array of technology. Excluding the baseline imaging devices, they need to learn to use the picture archiving and communication systems (PACS) (both the old one and a new version, which is still under development, running simultaneously), a voice recognition system (also in development) that is running simultaneously with the old digital recording system, the radiology information system (RIS), a different PACS for outside venues, a different Veterans Hospital PACS next door, the in-house clinical information system, another dictation system for an outside hospital, and a variety of software for at-home access and utilization of many of these systems. This arrangement is probably not too dissimilar to many other modern radiology departments.

Although the younger members of the staff seem to have an inherent ability to acquire the needed skills amazingly quickly, many of the elders, baptized in the 5.25-inch disk or “hard-drive-on-a-floppy” era, struggle to keep up. Frankly, just the number of passwords one needs to hold onto is crushing me. I need to carry a PDA just to hold onto them all (which means that I need to know how to use that too!).

Still, like many of us, I am a kid who likes new toys, and I can appreciate the advantages that much of this stuff provides toward efficiently running an imaging department and hospital (not to mention the entire business world). At the same time, I can identify with some of the sentiments of that wild and crazy guy, Ted Kaczynski, alias The Unabomber. As you probably remember, Ted wrote a long, somewhat rambling manifesto concerning, among other things, the damaging effects of technology on man and society. A few of Ted’s thoughts:

Unfortunately, Ted decided to emphasize his views using letter bombs—another quirky use of technology itself and, thus, a cruel irony.

Certainly, we all feel stress as we cope to understand our medical imaging technology, apply our knowledge to the products of that technology, and try to get our interpretations quickly to where they will do some good for our patients. While I am in no way an expert on computers or technology in general, I have a few suggestion or impressions that might ease the strain a bit.

The forward march of technology is inevitable, and, as radiologists, we stand right in its path. March along as best you can and ask others to help support you. Don’t give up and get trampled. Just imagine one day lying on a beautiful beach wearing high-tech sunglasses that project wirelessly transmitted images onto your retinas, dictating into a barely visible microphone, and getting a massage. If you want it and will buy it, the technology to make it happen can’t be far behind.