LAUSR

Inspired by the “Green New Deal,” diagnostic radiology (DxR) should design and adopt a “Smart New Deal;” “smart” as in smartphones. DxR would be wise to follow Wayne Gretzky’s advice, “... skate to where the puck will be.” That puck is the sophisticated mobile, small-screen communication device in the form of smartphones, tablets, iPads, etc. In this article, for brevity, “smartphone” is used as shorthand for those well-honed devices which combine compact, sturdy hardware (H/W) with integrated, intelligent software (S/W). Smartphones are an essential professional accoutrement tucked into purses, sport coats, or jean pockets. Ubiquitous smartphones communicate information, establish relationships, and shape healthcare experiences. A “Smart New Deal” can serve as a force function for DxR to enter this decade’s expanding communication era by revamping the efficiency and effectiveness of DxR’s main product—the report. Those reports need to broaden their distribution; more intelligently organize information; and minimize the cognitive distance between understanding its information and making decisions or taking actions [1, 2]. Reports must curate information so it is transformed into knowledge via understanding [3]. Smartphones’ wide availability and distribution offer continual access to knowledge at the time, place, and moment it is needed by increasingly mobile and flexibly scheduled physicians, healthcare workers, and patients [4]. Leveraging these features will improve patient satisfaction with DxR and elevate its value [5]. Early use of smartphones in COVID-19 AI research revealed broadening of (rural) sampling representation [6]. Smartphone patient portals can save money [7–10]. Unfortunately, smartphone apps popular with patients are currently less popular with radiologists [11]. Radiology uses smartphones for operational functions such as scheduling or patient exam preparation, but not for its core business, conveying understandable diagnostic information. It will take some “creative destruction” for radiology to create smartphone-information interfaces designed for physicians and patients. The corporatization and industrialization of radiology will increase investment in these interfaces, possibly by non-traditional disruptive players setting new web-based standards. These interfaces will incorporate explanations of quantitation and annotation of key images, multimedia image presentations, and hyperlinks to other relevant information (clinical, genetic, etc.) or links to pertinent, up-to-date, scientific references. This trend will follow internet information giants setting of standards (Microsoft acquired Nuance) in interoperability of interactive webpage use and of “cloud” technologies for processing and storage. A “Smart New Deal” can unshackle radiology from the stagnant 8.5′′ × 11′′ paper report format. Smartphone reporting will accelerate redesign and stimulate reassessment of DxR reporting philosophy. That philosophy should contemplate the concept of time becoming individually scarce when information becomes abundant, which it has. A largesse of information actually creates a scarcity of time, a non-renewable resource [12, 13]. Continuously available smartphone reports address this scarcity by letting users filter and choose the time and place of viewing the report [14]. The smartphone force function underlines information theorist Herbert Simon’s quote, “What information consumes is rather obvious: it consumes the attention of its recipients. Hence a wealth of information creates a poverty of attention and a need to allocate that attention efficiently among the overabundance of information sources that might consume it” [15]. Radiologic information on the smartphone must capture and hold user attention, but because attention consumes time, the report must convey high information content in a minimum amount of time, i.e., a high information to low user time ratio (ITR). This is a prerequisite for report redesign and favors a focused radiology reporting app rather than a “buried” EHR subpage. Total user time, therefore, * Dieter R. Enzmann [email protected]