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1.  Creating Accountability in Image Quality Analysis. Part 2: Medical Imaging Accreditation 
Journal of Digital Imaging  2013;26(3):371-374.
doi:10.1007/s10278-013-9605-8
PMCID: PMC3649039  PMID: 23595872
2.  Commoditization of PACS and the Opportunity for Disruptive Innovation 
Journal of Digital Imaging  2013;26(2):143-146.
doi:10.1007/s10278-013-9584-9
PMCID: PMC3597945  PMID: 23430404
3.  Creating Accountability in Image Quality Analysis Part 1: the Technology Paradox 
Journal of Digital Imaging  2013;26(2):147-150.
doi:10.1007/s10278-013-9583-x
PMCID: PMC3597953  PMID: 23455652
4.  Expanding the Functionality of Speech Recognition in Radiology: Creating a Real-Time Methodology for Measurement and Analysis of Occupational Stress and Fatigue 
Journal of Digital Imaging  2012;26(1):5-9.
While occupational stress and fatigue have been well described throughout medicine, the radiology community is particularly susceptible due to declining reimbursements, heightened demands for service deliverables, and increasing exam volume and complexity. The resulting occupational stress can be variable in nature and dependent upon a number of intrinsic and extrinsic stressors. Intrinsic stressors largely account for inter-radiologist stress variability and relate to unique attributes of the radiologist such as personality, emotional state, education/training, and experience. Extrinsic stressors may account for intra-radiologist stress variability and include cumulative workload and task complexity. The creation of personalized stress profiles creates a mechanism for accounting for both inter- and intra-radiologist stress variability, which is essential in creating customizable stress intervention strategies. One viable option for real-time occupational stress measurement is voice stress analysis, which can be directly implemented through existing speech recognition technology and has been proven to be effective in stress measurement and analysis outside of medicine. This technology operates by detecting stress in the acoustic properties of speech through a number of different variables including duration, glottis source factors, pitch distribution, spectral structure, and intensity. The correlation of these speech derived stress measures with outcomes data can be used to determine the user-specific inflection point at which stress becomes detrimental to clinical performance.
doi:10.1007/s10278-012-9540-0
PMCID: PMC3553361  PMID: 23053910
Stress; Voice analysis; Speech recognition
5.  Innovating Through Measurement 
Journal of Digital Imaging  2012;26(1):2-4.
doi:10.1007/s10278-012-9559-2
PMCID: PMC3553373  PMID: 23207924
6.  Using Analysis of Speech and Linguistics to Characterize Uncertainty in Radiology Reporting 
Journal of Digital Imaging  2012;25(6):703-707.
doi:10.1007/s10278-012-9535-x
PMCID: PMC3491157  PMID: 23053909
11.  The Insidious Problem of Fatigue in Medical Imaging Practice 
Journal of Digital Imaging  2011;25(1):3-6.
doi:10.1007/s10278-011-9436-4
PMCID: PMC3264708  PMID: 22143410
12.  Optimizing Technology Development and Adoption in Medical Imaging Using the Principles of Innovation Diffusion, Part II: Practical Applications 
Journal of Digital Imaging  2011;25(1):7-10.
Successful adoption of new technology development can be accentuated by learning and applying the scientific principles of innovation diffusion. This is of particular importance to areas within the medical imaging practice which have lagged in innovation; perhaps, the most notable of which is reporting which has remained relatively stagnant for over a century. While the theoretical advantages of structured reporting have been well documented throughout the medical imaging community, adoption to date has been tepid and largely relegated to the academic and breast imaging communities. Widespread adoption will likely require an alternative approach to innovation, which addresses the heterogeneity and diversity of the practicing radiologist community along with the ever-changing expectations in service delivery. The challenges and strategies for reporting innovation and adoption are discussed, with the goal of adapting and customizing new technology to the preferences and needs of individual end-users.
doi:10.1007/s10278-011-9409-7
PMCID: PMC3264714  PMID: 21769690
Innovation adoption; Structured reporting; Medical imaging
13.  Optimizing Technology Development and Adoption in Medical Imaging Using the Principles of Innovation Diffusion, Part I: Theoretical, Historical, and Contemporary Considerations 
Journal of Digital Imaging  2011;24(5):750-753.
The pioneering work performed in the social sciences on diffusion of innovation can be applied to medical imaging and shed valuable insights as to how innovation is analyzed and adopted within the population of end-users. Successful innovation must take into account unique stakeholder differences, changes in communication and social interactions, and shifting priorities in market economics. The dramatic changes currently underway in current medical imaging practice provides unique innovation opportunities to those individuals and companies which can utilize this knowledge and effect change in objective and reproducible means. Successful innovation should rely upon data-driven objective analysis, which can scientifically validate the inherent strengths and weaknesses of the innovation, when compared with the idea or technology it supercedes.
doi:10.1007/s10278-011-9397-7
PMCID: PMC3180547  PMID: 21710318
Innovation; Technology development; Data mining
14.  Transforming Health Care Service Delivery and Provider Selection 
Journal of Digital Imaging  2011;24(3):373-377.
Commoditization pressures in medicine have risked transforming service provider selection from “survival of the fittest” to “survival of the cheapest.” Quality- and safety-oriented mandates by the Institute of Medicine have led to the creation of a number of data-driven quality-centric initiatives including Pay for Performance and Evidence-Based Medicine. A synergistic approach to creating quantitative accountability in medical service delivery is through the creation of consumer-oriented performance metrics which provide patients with objective data related to individual service provider quality, safety, cost-efficacy, efficiency, and customer service. These performance metrics could in turn be customized to the individual preferences and health care needs of each individual patient, thereby providing an objective methodology for service provider selection while empowering health care consumers.
doi:10.1007/s10278-011-9379-9
PMCID: PMC3092052  PMID: 21468775
Patient empowerment; Quality performance; Data mining
15.  Improving Healthcare Delivery Through Patient Informatics and Quality Centric Data 
Journal of Digital Imaging  2011;24(2):177-178.
doi:10.1007/s10278-011-9363-4
PMCID: PMC3056976  PMID: 21274589
16.  Customization of Medical Report Data 
Journal of Digital Imaging  2010;23(4):363-373.
Structured reporting offers a number of theoretical advantages, perhaps the most important of which is creation of standardized report databases. The standardized data created can in turn be used to customize data display, report content, historical data retrieval, interpretation analysis, and results communication in both a context and user-specific manner. In addition, these referenceable report databases can be used to facilitate the practice of evidence based medicine, through data-driven meta-analysis and determination of best practice guidelines. This concept will only be realized if the customized data delivery technology provides real and tangible value to end users, accentuates workflow, can be seamlessly integrated into existing information system technologies, and be shown to yield reproducibility of the evidence domain. The time is here for the medical imaging and clinical communities to embrace this vision in order to improve clinical outcomes and patient safety.
doi:10.1007/s10278-010-9307-4
PMCID: PMC3046662  PMID: 20567993
Structured reporting; data customization; evidence-based medicine; data mining; decision support
17.  The Challenges, Opportunities, and Imperative of Structured Reporting in Medical Imaging 
Journal of Digital Imaging  2009;22(6):562-568.
Despite dramatic innovation in medical imaging and information system technologies, the radiology report has remained stagnant for more than a century. Structured reporting was created in the hopes of addressing well-documented deficiencies in report content and organization but has largely failed in its adoption due to concerns over workflow and productivity. A number of political, economical, and clinical quality-centric initiatives are currently taking place within medicine which will dramatically change the medical landscape including Pay for Performance, Evidence-Based Medicine, and the Physician Quality Reporting Initiative. These will collectively enhance efforts to improve quality in reporting, stimulate new technology development, and counteract the impending threat of commoditization within radiology. Structured reporting offers a number of unique opportunities and advantages over traditional free text reporting and will provide a means for the radiology community to add value to its most important service deliverable the radiology report.
doi:10.1007/s10278-009-9239-z
PMCID: PMC2782125  PMID: 19816742
Quality; reporting; pay for performance; evidence-based medicine
18.  The Challenges, Opportunities, and Imperative of Structured Reporting in Medical Imaging 
Despite dramatic innovation in medical imaging and information system technologies, the radiology report has remained stagnant for more than a century. Structured reporting was created in the hopes of addressing well-documented deficiencies in report content and organization but has largely failed in its adoption due to concerns over workflow and productivity. A number of political, economical, and clinical quality-centric initiatives are currently taking place within medicine which will dramatically change the medical landscape including Pay for Performance, Evidence-Based Medicine, and the Physician Quality Reporting Initiative. These will collectively enhance efforts to improve quality in reporting, stimulate new technology development, and counteract the impending threat of commoditization within radiology. Structured reporting offers a number of unique opportunities and advantages over traditional free text reporting and will provide a means for the radiology community to add value to its most important service deliverable the radiology report.
doi:10.1007/s10278-009-9239-z
PMCID: PMC2782125  PMID: 19816742
Quality; reporting; pay for performance; evidence-based medicine
19.  The Clinical Imperative of Medical Imaging Informatics 
Journal of Digital Imaging  2009;22(4):345-347.
doi:10.1007/s10278-009-9195-7
PMCID: PMC2706982  PMID: 19415384
21.  Intellectual Property in Medical Imaging and Informatics: The Independent Inventor’s Perspective 
Journal of Digital Imaging  2008;21(1):3-8.
While innovation and new product development is traditionally thought of as the exclusive domain of industry and academia, a large number of innovations in medicine and information technology have come from independent inventors, which account for almost 30% of new patents issued in the U.S. today. A large number of economic, political, and legal challenges exist within the current marketplace that serves as relative impediments to independent invention. This article explores the existing challenges facing the independent inventor and offers a number of recommendations and resources to facilitate independent inventors in their quest for innovation and entrepreneurship. The concept of “outsourcing innovation” is discussed as an alternative to the existing model of industry sponsored research and development (R&D), with the goal of combining the unique attributes and strengths of independent inventors and industry sponsors.
doi:10.1007/s10278-007-9096-6
PMCID: PMC2257992  PMID: 18175182
Intellectual property; invention; medical informatics
22.  Intellectual Property in Medical Imaging and Informatics: The Independent Inventor’s Perspective 
Journal of Digital Imaging  2008;21(1):3-8.
While innovation and new product development is traditionally thought of as the exclusive domain of industry and academia, a large number of innovations in medicine and information technology have come from independent inventors, which account for almost 30% of new patents issued in the U.S. today. A large number of economic, political, and legal challenges exist within the current marketplace that serves as relative impediments to independent invention. This article explores the existing challenges facing the independent inventor and offers a number of recommendations and resources to facilitate independent inventors in their quest for innovation and entrepreneurship. The concept of “outsourcing innovation” is discussed as an alternative to the existing model of industry sponsored research and development (R&D), with the goal of combining the unique attributes and strengths of independent inventors and industry sponsors.
doi:10.1007/s10278-007-9096-6
PMCID: PMC2257992  PMID: 18175182
Intellectual property; invention; medical informatics
23.  Pay for Performance (P4P) in Medical Imaging: The Time Has (Finally) Come 
Journal of Digital Imaging  2006;19(4):289-294.
doi:10.1007/s10278-006-1053-2
PMCID: PMC3045155  PMID: 17136488
24.  Defining the PACS Profession: An Initial Survey of Skills, Training, and Capabilities for PACS Administrators 
Journal of Digital Imaging  2005;18(4):252-259.
The need for specialized individuals to manage picture archiving and communications systems (PACS) has been recognized with the creation of a new professional title: PACS administrator. This position requires skill sets that bridge the current domains of radiology technologists (RTs), information systems analysts, and radiology administrators. Health care organizations, however, have reported difficfiulty in defining the functions that a PACS administrator should perform—a challenge compounded when the tries to combine this complex set of capabilities into one individual. As part of a larger effort to define the PACS professional, we developed an extensive but not exclusive consensus list of business, technical, and behavioral competencies desirable in the dedicated PACS professional. Through an on-line survey, radiologists, RTs, information technology specialists, corporate information officers, and radiology administrators rated the importance of these competencies. The results of this survey are presented, and the implications for implementation in training and certification efforts are discussed.
doi:10.1007/s10278-005-8146-1
PMCID: PMC3046727  PMID: 16249838
PACS administrator; PACS; radiology management; information systems management
25.  Evolution of the Digital Revolution: A Radiologist Perspective 
Journal of Digital Imaging  2004;16(4):324-330.
The transformation from film-based to filmless operation has become more and more challenging, as imaging studies expand in size and complexity. To adapt to these changes, radiologists must proactively develop new workflow strategies to compensate for increasing work demands and the existing workforce shortage. This article addresses the evolutionary changes underway in the radiology interpretation process and reviews changes that have occurred in the past decade. These include a number of developments in soft-copy interpretation, which is migrating from a relatively static process, duplicating film-based interpretation, to a dynamic process, using multi-planar reconstructions, volumetric navigation, and electronic decision support tools. The result is optimization of the human–computer interface with improved productivity, diagnostic confidence, and interpretation accuracy.
doi:10.1007/s10278-003-1743-y
PMCID: PMC3044070  PMID: 14747936
evolution of radiology practice; radiology interpretation; Transforming the Radiology Interpretation Process (TRIP)

Results 1-25 (34)