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The last few years have seen significant disruption to delivery and consumption of consumer data. When Netflix focused more on demand streaming of content, Blockbuster filed for bankruptcy. Amazon is now delivering books digitally while Borders is closing stores and filed for bankruptcy. Apple's MacBook Air, which uses Flash Storage, doesn't have space for CD or DVD players. And due to Spotify and iTunes, most music is now streamed or downloaded across the Internet.

So what is the most common method of transfer of diagnostic images and messages in 2011?
Today burning a CD/DVD and sending them via FedEx or a courier is the most common method to transfer images. Really? If you were not familiar with this method, would you ever think that this is how we transfer information? When we think of what is happening on the consumer side with books, movies and music, we can see it isn't a question of technology or bandwidth.

Think about this for a minute. We are able to look inside people's bodies. In the history of the world what we are doing on a daily basis is amazing. But when we need to transfer these images to another location we actually still have a person pick up a hardcopy and physically carry it over. This is amazing that we use Pony Express technology to transfer some of the most sophisticated technology in the world. So the cycle of innovation here is: relay running Incas, horses, cars, and airplanes? How far we have come!

Thankfully there are some companies trying to tackle this problem. Among them are eMix, SeeMyRadiology, and LifeImage.

Last week I attended a presentation from MIT Enterprise Forum by Florent Saint-Clair, General Manager of eMix. eMix, which stands for Electronic Medical Information Exchange is a new company incubated by San Diego PACS company DR Systems. eMix has developed technology that enables secure sharing of images and reports among disparate institutions and physicians via the Internet. It is vendor neutral, despite being incubated by a PACS company. Their software of course uses DICOM and HL7 standards.

In the presentation, Saint-Clair said the two major issues confronting eMix are actually business related —not technological. First, can eMix move from their initial pricing to a sustainable price without alienating current customers? Second, how can eMix segment their customers to better articulate their respective value propositions? There was a good discussion during the program about strategy and implementation.

It is interesting that the technology isn't the problem, but the user adoption. Geoffrey Moore has outlined in his books the technology adoption lifecycle. First the innovators and early adopters try out the new technology. Eventually the early and late majority will jump in and start to use the technology. So while eMix and the other image transfer services may be growing slower than what they would like, there is still hope. They are early in the lifecycle.

The day is on the horizon when most images will no longer be sent using Pony Express technology.

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David Fuhriman is Managing Partner at Bern Medical, where he analyzes radiology data to discover under-billings. He is involved in high tech-startups in San Diego and in helping technology improve our world. He can be reached at



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