From “Imaging 2.0” to “Imaging 3.0”

On the Crises of Radiology and Its “Culture Shifts”
Chapter
Part of the Technikzukünfte, Wissenschaft und Gesellschaft / Futures of Technology, Science and Society book series (TEWG)

Abstract

Two major technological turnovers led to a crisis in the disciplinary self-conception of clinical radiology within the last 20 years. In the late 1990s, the transformation of analogue visualization techniques and diagnostic workflows into all-digital environments challenged the radiological modes of processing and reading medical images. This so-called analogue-digital migration fundamentally transformed the diagnostic process into a fully digital one. The analysis of user modeling processes and of its implementation in everyday work routines demonstrates the interdisciplinary tensions between radiology and, in particular, software design on how to conceptualize a discipline and its novel digitally-based work practices. More recently, the use of imaging techniques and visualization technologies in other medical disciplines causes strategic and political campaigns such as Imaging 3.0 to claim radiology’s very own professional position in changing clinical environments and in health care policy decisions. Radiology tries to demand back its leading role as a clinical discipline with long-lasting traditions of visual expertise by simultaneously opening to new political demands such as patient-centered health care. The analysis of tumor boards illustrates the multidisciplinary contexts of today’s cancer treatment regimes and thereby points to the contested status of radiology as a discipline with a very specific visual expertise. I will explore the professional “crises” and proclaimed culture shift s of radiology in the course of the analogue-digital migration as well as the Imaging 3.0 campaign by focusing on the relations between conceptual developments on a more macroscopic level and their impact on everyday practices within radiological settings.

Keywords

Technological innovation User-modeling Image-guided intervention Visual expertise Clinical radiology 

Notes

Acknowledgments

My research was funded by the German Federal Ministry of Education and Research (01UB0925A) as well as by the DFG Cluster of Excellence 1027 “Image Knowledge Gestaltung. An Interdisciplinary Laboratory”.

References

  1. Ärztekammer Berlin (2012) Weiterbildungsordnung der Ärztekammer Berlin, version effective 17 March 2012. http://www.aerztekammer-berlin.de/10arzt/15_Aerztliche_Weiterbildung/10_wbo/00_WbO_2004_inkl_1_bis_9_Nachtrag.pdf. Accessed 15 March 2014
  2. Agfa HealthCare (2007) IMPAX Insights #1—Persona-based workflow design. Supporting the workflow needs of individual users. http://www.agfahealthcare.com/he/global/en/internet/main/products_services/product-info/white_papers/persona_based_workflow_design.jsp. Accessed 28 Jan 2015
  3. Agfa HealthCare (2013) IMPAX agility, White Paper—Persona based approach. http://www.agfahealthcare.com/global/en/main/resources/white_papers/index.jsp. Accessed 15 Aug 2013
  4. Alač M (2011) Handling digital brains. A laboratory study of multimodal semiotic interaction. MIT, CambridgeGoogle Scholar
  5. Andriole KP, SCAR TRIP Subcommittee (2004) Addressing the coming radiology crisis. The Society for Computer Applications in Radiology Transforming the Radiological Interpretation Process (TRIP™) Initiative. J Digit Imaging 17(4):235–243Google Scholar
  6. Bannon L (1995) The politics of design: representing work. Commun ACM 38:66–68CrossRefGoogle Scholar
  7. Bannon L (2000) Situating workplace studies within the human-computer interaction field. Cambridge University Press, CambridgeCrossRefGoogle Scholar
  8. Berry DM (2011) The philosophy of software: code and mediation in the digital age. Palgrave Macmillan, LondonCrossRefGoogle Scholar
  9. Bryan RN (2003) The digital rEvolution. The millennial change in medical imaging. Radiology 229(2):299–304CrossRefGoogle Scholar
  10. Burri RV (2008) Doing distinctions. Boundary work and symbolic capital in radiology. Soc Stud Sci 38(1):35–62Google Scholar
  11. Cooper A (1999) The inmates are running the asylum. Why hi-tech products drive us crazy and how to restore the sanity. Sams Publishing, IndianapolisGoogle Scholar
  12. Coopmans C (2011) “Face value”: new medical imaging software in commercial view. Soc Stud Sci 41(2):155–176CrossRefGoogle Scholar
  13. Cross N (2001) Designerly ways of knowing. Design discipline versus design science. Des Issues 17(3):49–55CrossRefGoogle Scholar
  14. Dodge M, Kitchin R (2011) Code/space: software and everyday life. MIT Press, CambridgeGoogle Scholar
  15. Dourish P (2001) Where the action is. The foundations of embodied interaction. MIT Press, CambridgeGoogle Scholar
  16. Dourish P (2006) Implications for design. Proceedings of the ACM conference human factors in computing systems. IEEE Computer Society Press, Los Alamitos, CA, pp 541–550CrossRefGoogle Scholar
  17. Dreyer KJ, Hirschorn DS, Thrall JH, Mehta A (eds) (2006) PACS. A guide to the digital revolution, 2nd edn. Springer, New YorkGoogle Scholar
  18. Ellenbogen PH (2013) Imaging 3.0. What is it? J Am Coll Radiol 10(4):229CrossRefGoogle Scholar
  19. Fleck L (1979 [1935]) Genesis and development of a scientific fact. University of Chicago Press, ChicagoGoogle Scholar
  20. Fleck L (1986 [1936]) The problem of epistemology. In: Cohen RS, Schnelle T (eds) Cognition and fact. Materials on Ludwik Fleck. Reidel, Dordrecht, pp 79–113Google Scholar
  21. Forsythe DE (2001 [1992]) Blaming the user in medical informatics. The cultural nature of scientific practice. In: Hess DJ (ed) Studying those who study us. An anthropologist in the world of artificial intelligence. Stanford University Press, Stanford, pp 1–16Google Scholar
  22. Fridell K, Edgren L, Lindsköld L, Aspelin P, Lundberg N (2007) The impact of PACS on radiologists work practice. J Digit Imaging 20(4):411–421CrossRefGoogle Scholar
  23. Glazer GM, Ruiz-Wibbelsmann JA (2011) The invisible radiologist. Radiology 258(1):18–22CrossRefGoogle Scholar
  24. Goldsmith J (2011) The future of radiology in the new health care paradigm. The Moreton Lecture. J Am Coll Radiol 8(3):159–163CrossRefGoogle Scholar
  25. Gould MK (2011) Multidisciplinary approach to the evaluation of the lung cancer patient. In: Kernstine KH, Reckamp KL (eds) Lung cancer. A multidisciplinary approach to diagnosis and management. Demos Medical Publishing, New York, pp 7–42Google Scholar
  26. Helmberger T, Martí-Bonmatí L, Pereira P, Gillams A, Martínez J, Lammer J, Malagari K, Gangi A, de Baere T, Adam JE, Rasch C, Budach V, Reekers JA (2013) Radiologists’ leading position in image-guided therapy. Insights Imaging 4(1):1–7CrossRefGoogle Scholar
  27. Hirschorn DS (2006) Introduction. In: Dreyer KJ, Hirschorn DS, Thrall JH, Mehta A (eds) PACS. A guide to the digital revolution, 2nd edn. Springer, New York, pp 3–6Google Scholar
  28. Howell WLJ (2013) Imaging 3.0: Radiology gets a facelift. http://www.diagnosticimaging.com/practice-management/imaging-30-radiology-gets-facelift. Accessed 20 Sept 2013
  29. Jaffray DA (2012) Image-guided radiotherapy: from current concept to future perspectives. Nature Rev Clin Oncol 9(12):688–699CrossRefGoogle Scholar
  30. Krupinski EA, Kallergi M (2007) Choosing a radiology workstation: technical and clinical considerations. Radiology 242(3):671–682CrossRefGoogle Scholar
  31. Larsson W, Aspelin P, Bergquist M et al (2007) The effects of PACS on radiographer’s work practice. Radiography 13:235–240CrossRefGoogle Scholar
  32. Levin DC, Rao VM, Berlin J (2013) Ensuring the future of radiology: how to respond to the threats. J Am Coll Radiol 10(9):647–651CrossRefGoogle Scholar
  33. Levin DC, Rao VM, Bree RL, Neiman HL (1999) Turf battles in radiology: how the radiology community can collectively respond to the challenge. Radiology 211(2):301–305CrossRefGoogle Scholar
  34. Manovich L (2008) Software takes command. http://lab.softwarestudies.com/2008/11/softbook.html. Accessed 8 Nov 2011
  35. Matsumoto AH, Adams MJ, Bello JA, Lozano K, Rosenthal SA, Swan TL (2013) Commentary on “culture shift”—radiologists and radiation oncologists adding value to the health care system. J Am Coll Radiol 10(2):99–100CrossRefGoogle Scholar
  36. Mayhew DJ (1999) The usability engineering lifecycle. A practitioner’s handbook for user interface design. Morgan and Kaufmann Publishers, San FranciscoGoogle Scholar
  37. Muroff LR (2013) Culture shift: an imperative for future survival. J Am Coll Radiol 10(2):93–98CrossRefGoogle Scholar
  38. Reiner BI, Siegel EL, Siddiqui K (2003) Evolution of the digital revolution: a radiologist perspective. J Digit Imaging 16(4):324–330CrossRefGoogle Scholar
  39. Siegel EL, Reiner BI, Knight N (2006) Reengineering workflow. The radiologist’s perspective. In: Dreyer KJ, Hirschorn DS, Thrall JH, Mehta A (eds) PACS. A guide to the digital revolution, 2nd edn. Springer, New York, pp 97–123Google Scholar
  40. Star SL, Strauss A (1999) Layers of silence, arenas of voice: the ecology of visible and invisible work. Comp Supp Coop Work 8(1):9–30CrossRefGoogle Scholar
  41. Tellioğlu H, Wagner I (2001) Work practices surrounding PACS. The politics of space in hospitals. Comp Supp Coop Work 10(2):163–188CrossRefGoogle Scholar
  42. Thrall JH (2005) Reinventing radiology in the digital age, part I. The all-digital department. Radiology 236(2):382–385CrossRefGoogle Scholar
  43. Trogemann G (2010) Code and machine. In: Gleiniger A, Vrachliotis G (eds) Code: between operation and narration. Birkhäuser, Basel, pp 41–54Google Scholar

Copyright information

© Springer Fachmedien Wiesbaden GmbH 2016

Authors and Affiliations

  1. 1.BerlinGermany

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