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Risky Business?

January 8, 2015
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For Christmas, I received and read an interesting book entitled “Taking Risks” by Walt Robb, Meadow Brook Farm Publishing, 2014 (http://www.mbfpublishing.com/).  Walt was the general manager of the GE Medical Systems business when I arrived in March, 1976 as the fourth person into the CT organization.  He was instrumental for putting GE on the map in CT and MRI technologies – mainly by taking risks.

In his book, Walt makes the case for getting ahead in business and in life by taking risks.  His book recounts many of his life experiences from his childhood through to his current technology consulting endeavors, and how risk has played a role in shaping these events. 

For me, the chapters on his GE experience were like a walk down memory lane.  The early days of CT were some of the most exciting in my work experience.  GE did take a huge risk at the time by jumping to a third-generation fan-beam geometry design, and through the efforts of many, it turned out to be a very successful decision.  I can still see the early CT detectors – they looked like something out of the Mercury space program!  There were many dark moments with the technology, but through teamwork and risk taking, the organization made it a success.

Having spent close to forty years in the industry, I have to agree with Walt’s premise – there doesn’t seem to be as much risk-taking among the major companies as in the early years of digital imaging.  Where is the next CT or MRI technology?  There have been many refinements, but perhaps no new major technologies to speak of in over twenty years.

I wonder how ARRA/MU would have been addressed with more risk taking, and would it have made a major difference in the way companies have addressed it?  Should companies have taken more risk in bringing out EMR’s and digital information systems?  Would there be a greater ability to share health information for accountable care if companies were willing to take more risk? 

Risk applies not just to the vendors.  Walt recounts how the University of California at San Francisco (UCSF) wrestled with whether to use the GE fast scan whole body scanner, or acquire another EMI head scanner.  In the end, they took the risk of acquiring the whole body scanner, and whole body CT took off.  What if they had played it safe with another head scanner?  They would have avoided taking a risk and ended up behind in terms of whole body CT.

Today, analytics are gaining in popularity and are shaping decision making in healthcare.  Capabilities like decision support might allow for safer, more cost effective procedures, but are they also stifling diagnostic creativity by reducing risk?  I know if I had the option of the choice between diagnosticians playing it safe, versus taking some risk, which way I would want them to go!

The current auto and space industries remind me of the early days of CT.  What would the state of the electric car be today without Elon Musk?  The same for space exploration and his SpaceX company.  Perhaps it’s time for an Elon Musk in the healthcare IT arena. 

I encourage you all to read Walt’s book, and as usual, your comments are welcome and encouraged!  Please share any examples of how risk taking has paid off for you.

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