Technologies on the Cusp
New technologies often follow a meandering path to clinical use. Adoption may be accelerated, either by a breakthrough clinical study validating its use or grants or other incentives designed to spur adoption. Conversely, technological innovations may sputter and stumble, owing to financial, technical or regulatory barriers.

The features in this month’s issue of Health Imaging illustrate the complex and varied roadmaps that new technologies can take.

Health information exchanges (HIE) represent a vital component of a functional healthcare system, enabling varied and disparate organizations to electronically share patient data, including, in theory, images. While more than 250 HIEs have gotten off the ground, few have achieved financial sustainability and only a fraction are managing to exchange images.

Consider, for example, Southern Tier Health Link, which launched with the aid of $11.3 million in funding from New York State. Today, the HIE is one of a handful supported by hospital and payor funding. Other HIEs find it difficult to persuade stakeholders to ante up financial support despite the clear benefits of managed inter-organization data exchange.

Another goal for many HIEs is image exchange. But the combination of less-than-secure financial footing and technical barriers seems to be stalling this goal for many HIEs.

On the modality front, 7T MRI is making inroads. It may be ideal for several niche applications, particularly in neuroimaging. Similar to HIEs, these systems are expensive to deploy and maintain, with a price tag of approximately $1 million per Tesla. Researchers are not overpromising, but deliberately and carefully framing a clear case for specific uses, such as surgical planning for temporal lobe epilepsy.

The recent uptick of natural language processing (NLP) illustrates the value of public-private partnerships. In August 2011, University of Pittsburgh Medical Center entered into a 10-year joint development agreement with an NLP vendor. The influx of funding, paired with the university’s intellectual capital, is accelerating research into relevant, real-world NLP applications.

The road that new technologies follow is seldom smooth and barrier-free, which holds true on all levels: research and development, system-wide validation and adoption and single-site implementation. Hopefully, the examples within this issue will help you anticipate and steer clear of the road bumps you encounter as you integrate technologies on the cusp.