The deftness of data movement between sites creates a deception that it’s easy; it’s not. Leaving aside technical problems with integration, servers, and storage, the more central problem might be this: Who pays the bill to set image exchange in motion?

My initial reaction was to flinch and move on, like a punch-drunk fighter, when I heard about the 90% assumed equipment-utilization rate in the omnibus bill intended to avert the fiscal cliff. Instead, I bear witness to the latest in a series of cuts to the technical and professional components of radiology reimbursement.

The data-intensive nature of radiology has long kept the specialty on the cutting edge of IT. That’s why cloud computing is a relatively old concept among imaging-informatics veterans.

The Argonauts (and Odysseus, after them) had to sail past rocky islands housing the enchanting Sirens. Their wonderful songs made sailors hurl themselves overboard and swim toward them, even as they died upon the jagged rocks. After my fifth birthday, however, I accepted that plugging my ears never makes bad news go away for long.

In a fast-paced market, the ability to defend a business against (and to take advantage of) disruption is crucial for staying ahead of the competition. Disruptions have traditionally altered the trajectory of many industries: Digital photography has rendered film obsolete, music downloads have diminished CD sales, and tablets have largely replaced netbooks

Perhaps because they don’t hang a sign out front, they aren’t located in one place, and they are (in a sense) virtual, accountable-care organizations (ACOs) have quietly blanketed nearly half the nation

The cardiac-imaging community, indeed any imaging community, should pay close attention to clinical trials. Why? The results of the trial will determine the rationale for imaging. The rationale will determine reimbursement, reimbursement will influence demand, and demand will affect supply. This is the new economics of imaging.

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