Tuesday, August 30, 2011

Distorted Reality?

Anonymous, who I think is from BDM Information Systems, a division of GE, left the following comment on my Buffett post after spending almost an hour perusing my site:
Your perception of reality is distorted. This is true for us all, but in your case it is pretty bad. If you are born with a lesser brain, raised poorly given poor education then you will not fare as well as your neighbours who were dealt better hands in life. You were lucky to become who you are. A decent brain, good upbringing (I assume). Now you don't want to share your luck with those less fortunate than you, and you insist on calling it hard work - not luck - failing entirely to recognise the gifts that made you work hard.
So here we are. The narcissistic Leftist generosity rears its distorted head. So...there are those who are just so far below us, so "unlucky" that we OWE it to them to share our "luck". A slightly different twist on the same old stuff. But stand and take notice, folks: Anonymous declares that these "unlucky" people have "lesser brains", the first time I have EVER heard this blatant discriminatory phrase come from the Left...or the Right, or anywhere else! Ten points for honesty, and by that I mean Anonymous has stated what he really thinks. If I were one of those "unlucky" folks, I might be offended. Of course, the Left has trained the "unlucky" to expect and demand that the "lucky" share their luck.

Notice that Anonymous removes ALL responsibility from the "unlucky". They are simply "unlucky", I guess. Their meager brain-power cannot process the consequences of their bad choices. And thus, we should "share the wealth" or the "luck" if you prefer. There is not thought of helping them improve themselves or their lot.  All we EVER hear is that the greedy "rich" won't help anyone. Siffle, sniffle.

Clearly, Anonymous didn't read the post, but assumed it said what he wanted it to say. Greedy, selfish Conservatives. Which is not what I said at all. Behold what the figures bear out: the "rich" or "lucky" are already paying all the federal taxes. I guess this isn't enough for the Left. The "lucky" apparently are expected to give everything to the unlucky until everyone's lot is equal. And the "lucky" are supposed to keep up the hard work, which apparently is a gift and not something they earned, so as to keep funneling adequate funds to the "unlucky".

I'm sorry, Bunky, but I think I do close to my share. Between federal, state, local, sales, capital gains, and whatever other taxes, I pay well over 50% of my income out to some government agency or another. That's a lot. In addition, My group writes off 10-15% of its income as bad debt, serving the underserved, or "unlucky", who cannot pay.

This argument played out on AuntMinnie.com recently. My friend Dr. Sardonicus pointed out:
I, and basically all of my radiology colleagues, give away 25-30% of our services. Give away, as in free. And then on the 70% that we do collect on, we lose about half of that in taxes. If you were radiologists, then you would know this.

My personal contribution to the poor through free care is many miilions of dollars (I am an experienced radiologist). So, I am pretty much immune to anyone trying to lay a guilt trip on me.

Now, if you personally feel guilt, then please take care of your guilt yourself, and leave me out of it. There are many opportunities to volunteer, and, I guarantee you that volunteering at a free clinic will be much more economically efficient than contributing the money you make at work to the government in the form of an additional check to the IRS. If you were to donate a days work worth of money to the IRS, I guarantee that by the time it got to any poor people it would be 1% of what you gave them, after all the bureaucratic friction in the system burned up the rest

But my friend Thor, who is a Leftie academic rad, poo-poo'd the thought of generosity:
Well goodness me gracious...how silly of me not to congratulate you on your many contributions to society. Now stop being so pious. You say all this yet I am sure you are not starving or wanting for anything, correct? You knew this was the situation when you went into Radiology correct? You do know that others pay higher fees to make up for your charity care and if everyone could pay your price would be lower so your not really "giving anything away", correct?
Sardonicus responded:
Disagree.

Hospitals are not the same as professional corporations. They can manage the amount of indigent care they give. (particularly for profits). Indigent care is often compensated by increasing fees in other areas, as I am sure you know. . .The hospitals are fat, they do not suffer from indigent care, they pass it on. Meaning - in the face of this vicious recession, in towns where other industries are failing, hospitals are complaining because their profit is somewhat lower.

On the other hand, physicians can't simply raise fees or divert indigent care to counter cuts in reimbursement. When people don't pay (like in the last two years), my pay goes down, while I am working longer hours than before. The decrease in my pay and increase in work is essentially an increase in contributions to charity care. The primary cares are in worse shape, and have been decimated over the past 10-20 years. They can't simply jack up their fee to insured patients. Not allowed, controlled economy. That is why you see many of them becoming employees of hospitals, or becoming essentially the overseer of an army of physician extenders, or refusing to accept medicaid/medicare.

So while you may have to pay higher insurance rates to cover the indigent, I also have to pay higher insurance rates, and my income is significantly down as well.

Thor: spare us the condescending, supercilious tone.

I rather expected someone would attack. I am not expecting beatification. I rarely talk about this, and yes I did expect to do charity care and it is part of the job. I have no problem giving away my services to those who need it. In fact, I have tried many times to give away my services to someone I knew was in need, only to be told by attorneys that it would be insurance fraud and I couldn't write it off, I had to bill them. I couldn't even whisper to them to ignore the bill. Did it anyway.

Here is the point you missed: Most people don't understand that we give away our services on a regular (like every hour of every day) basis. Mostly I don't care if they don't know. BUT when people start slinging mud about high earners taking and not giving, some education is in order.

And, as above, NO ONE pays higher fees to make up for my donated professional time. We cannot raise our fees. We are in a constant battle to reduce the amount they will be reduced by. (see thread on the new CMS rules which are designed specifically to pay radiologists less for their services). I know a surgeon in a small town in our state that was hit with high layoffs. Suddenly, her "no pays" became so high she was insolvent and had to close her practice and move to another town. The hospital, by the way, seems to be making it OK. In this situation, Thor, your assertion is that other patients would pay more and that would keep her income stable. Do you see that it doesn't work that way? (By the way - our group stayed in that hospital and is taking a big hit on the no pays. It is costing us money to stay in that hospital, we can't recoup the salary paid to the people we staff it with, so I feel it directly in my reduced paycheck. Again - your idea of how this works is incorrect).

I expect no sympathy, but I expect greater awareness. I expect not to be beaten up by those with a limited understanding of the real situation. What I would like to see is an understanding that every PP radiologist (OK, every PP physician) donates substantial amounts of his/her time to the cause of indigent care. Can we have a cessation of the discussion that doctors do not contribute enough? I know of no other profession, no other business that gives away as much as we do.
Anonymous, in his Leftist, narcissistic zeal to show what a wonderful, caring guy he is, disses the "lucky" for not wanting to do even more than they already do. I'll wager he doesn't pay the amount of tax I do, nor does he donate the services given away by my group. And as Dr. Sardonicus clearly points out, we DO give them away. I can pretty much guarantee that if Anonymous got really "lucky" and won the lottery, he wouldn't give the proceeds to charity, and he would complain loudly about the 50% bite Uncle Sam will remove from the winnings.

All I can do is wish everyone "Good Luck"!

GIDI-Up!
...and OUT!

A golden oldie post from 2007. We now have integrated digital voice recording, which magically crashed following server upgrades. Seems the XML codes from iRecorder aren't being heard by IMPAX. My partner Dr. Killer longs for the days of the GIDI. How nostalgia clouds our memories...



Image courtesy of: http://www.kinkelder.org/


Just about every medical student has read Sam Shem's novel, "The House of God" and most can recite the 13 Laws by heart:
    1. GOMERS DON’T DIE.
    2. GOMERS GO TO GROUND.
    3. AT A CARDIAC ARREST, THE FIRST PROCEDURE IS TO TAKE YOUR OWN PULSE.
    4. THE PATIENT IS THE ONE WITH THE DISEASE.
    5. PLACEMENT COMES FIRST.
    6. THERE IS NO BODY CAVITY THAT CANNOT BE REACHED WITH A #14 NEEDLE AND A GOOD STRONG ARM.
    7. AGE + BUN (Blood Urea Nitrogen) = LASIX DOSE.
    8. THEY CAN ALWAYS HURT YOU MORE.
    9. THE ONLY GOOD ADMISSION IS A DEAD ADMISSION.
    10. IF YOU DON’T TAKE A TEMPERATURE, YOU CAN’T FIND A FEVER.
    11. SHOW ME A MEDICAL RESIDENT WHO ONLY TRIPLES MY WORK AND I WILL KISS HIS FEET.
    12. IF THE RADIOLOGY RESIDENT AND THE MEDICAL STUDENT BOTH SEE A LESION ON THE CHEST X-RAY, THERE CAN BE NO LESION THERE.
    13. THE DELIVERY OF GOOD MEDICAL CARE IS TO DO AS MUCH NOTHING AS POSSIBLE.

I can attest to the fact that these laws are really fairly accurate. But I wanted to bend one of the laws a bit as an introduction to today's topic, the GIDI.
The GIDI is an example of Dalai's version of the 11th law: SHOW ME A PROGRAM OR TECHNOLOGY DESIGNED BY ENGINEERS FOR I.T. WITHOUT PHYSICIAN INPUT THAT ONLY TRIPLES MY WORK AND I WILL KISS IT. This will make sense shortly.

You are naturally asking, "What is a GIDI?" Well, the official title of this software extravaganza is "Generic IMPAX DTMF Integration," and it was designed to help us communicate reports to the outside world. It was a good idea, with all the right intentions, but we all know what the road to Hell is paved with, don't we?

Here's the problem the GIDI was designed to solve: We have Agfa Impax PACS, as if you didn't know, and we also have an older Dictaphone analogue voice dictation system. As we dictate happily along, there must be a way to enter the patient into the system for the transcriptionist to know whose report she is typing. Prior to the GIDI, we had the option of simply reading the patient ID, or the accession number, or something like that into the mike as the beginning of the dictation. There is also the option, if it is set up to do so, of keying in that same number with the pad on the dictaphone head-unit. From the Agfa GIDI manual:

GIDI was written because tones describing the images must be manually dialed into the dictation system. This is slow, tedious, and error prone.
I'll agree with that. So, Agfa was commissioned to write the GIDI!
GIDI introduces a more efficient workflow. The application automatically starts at boot time with Impax and waits for a user to press the "start dictation" button on Impax. GIDI is aware that the button has been pushed and uses the modem to dial into the dictation system a series of tones based on Impax study information and user specified settings. The radiologist then makes their recording. GIDI is also aware when the user presses the end dictation tone, which causes the Impax study to be updated such that the dictation is complete.
If you're interested, this is the control panel for the GIDI set-up.
On our particular Dictaphone implementation, The GIDI buys us two things: first, we don't have to enter the accession number (although we usually dictate it anyway), and second, the voice dictation can be called up by telephone from the system if you know the patient's ID. This allows for instant gratification when transcription turn-around just isn't good enough.
To this point, everything sounds great. Now, here's how it works in practice. A SoundBlaster board is placed in your workstation computer if there wasn't already one there, and it is connected to a modem output. The modem AND your dictaphone are connected in parallel to the telephone line. You start the GIDI by double-clicking its icon, if it didn't start by itself, or if it shut off, and then you activate the Dictaphone, which dials into the tank. When you begin a dictation by clicking the proper button, Mr. GIDI transmits the tones over the phone line, Dictaphone gives a voice prompt, and off you go. When done, you click the "Dictated" button, the termination tone is sent through, just like pressing "end" on the mike, and you are ready for the next victim.

Sounds pretty straight-forward, right? This should be a labor-saving device for all involved. Except for one little problem. It is a true pain in the backside to use. It was overengineered and undertested. In actual use, the tones are transmitted VERY SLOWLY. Yes, an extra 6 seconds per study is no big deal, unless you are reading 200 studies a day as we do some weekends. That would be 1200 seconds, or 20 minutes. Let's see...even an extra 10 minutes per day, working, say, 200 days per year, adds up to 2000 minutes or 33 hours. That would be just under four 9-hour working days per year. You get the idea. All that time wasted because of a program that is supposed to be helping me.

As Ron Popiel says, "Wait! That's not all!" The thing has a bad habit of hanging up the dictaphone, crashing IMPAX, or decoupling itself with the dictation system, requiring restarting of the GIDI, redialing into Dictaphone, and sometimes rebooting the computer altogether. So, add another 10-20 minutes to the daily toil. The system only allows dictating one exam at a time, so we have to re-GIDI every study on a multiple trauma patient. (And I'm talking about a CT of the head, C-spine, T-Spine, L-spine, chest, abdomen, pelvis, and at least one extremity, as well as CR's of all of the above, so there could be 10-20 different clicks for one patient.)

And, there's more! Occasionally, when the GIDI blows up, the study that was on the screen disappears, and if you weren't paying very close attention in those first few seconds, it is rather difficult to know who just left your screen. Thus, a number of studies are accidentally lost from the worklist, only to be rediscovered hours or days later.

The punch-line is that we don't even need the damn thing. Our human transcriptionists are rarely more than 10-20 minutes behind our dictations, and they are very good about getting STAT reports online, well, STAT! And, we type in our preliminaries for the ER, so they are not in desparate need of this technological tour de farce either. But no one will let it go.

Sadly, we have in the GIDI yet another example of a solution designed without regard to the actual workflow of the actual human being that actually uses it. Again and again and again, we are delivered products that the engineers (keep in mind, I am an engineer by training as well) think we should like, but never asked us if we actually do. Maybe it all boils down to communication. Somehow there needs to be dialogue between the end-users of these things and the folks that create them. Don't go looking for something you can patent, guys, but try to come up with something that will truly help me do my job. And please listen to me when I tell you how I do my job, don't just show me newer and shinier gadgets that you think will enhance my workflow. Most of the time, they just get in my way. Like the GIDI. Which really has to go. Soon. Very, very soon. Like today.

Tuesday, August 23, 2011

GE Moves To China
Anyone For A Linglong?


GE, in a vote of confidence for China, has moved the headquarters of its X-Ray division to Beijing. The Wall Street Journal says:
General Electric Co. said it is moving its X-ray business headquarters to China to accelerate sales in the country's fast-growing health-care market, the latest sign of China's growing importance to the giant U.S. conglomerate.

The X-ray unit will be the company's first business to be based in China. The business has already begun the move—which includes the unit's chief executive and three other members of its executive team—and expects to complete the process by year end, said Anne LeGrand, vice president and general manager of GE Healthcare Global X-Ray. The senior leadership team's move to Beijing is aimed in part at helping develop more medical equipment specifically for the Chinese market, Ms. LeGrand told a news briefing Monday.

GE said it doesn't expect the move to result in any job losses in the U.S., where the unit has been based in Waukesha, Wis. The Wisconsin X-ray division has 120 employees. The company also said it is too early to say how many employees it will hire for the unit's new Beijing headquarters.

"As the company grows more global, it's increasingly important for us to become close to our customers," Ms. LeGrand said, adding that she expects 20% to 25% of GE Healthcare's X-ray products to be developed in China during the next three to five years for sale around the world. . .

GE has long placed high hopes on China, with CEO Jeffrey Immelt in 2008 calling it the company's "second home market." In January, the company finalized a deal with state-owned Aviation Industry Corp. of China to inject much of GE's civilian avionics business into a 50-50 joint venture based in China. . .

Last year, GE invested a total of $2 billion in China, $500 million of which was allocated to what it calls customer innovation centers. Ms. LeGrand said most of that chunk was for the X-ray business. GE Healthcare last year launched the Brivo CT, a scaled-down CT scanner for use in China's less-developed primary-care hospitals, and in 2009, it rolled out a lower-cost digital X-ray device called the Linglong for China.
I'm gonna get me some Linglong, that's for sure. By the way, Linglong seems to be the name of a major tire company in China, based in Shandong (you can't make this stuff up, folks):


GE has fallen down the same hole they dug when they named their latest PET/CT after the Kia Optima cheapo inexpensive sedan from Korea. No offense to Linglong, or to Kia for that matter.

I'm not sure if GE will produce any PACS software in Beijing, although I assume PACS is used over there. I do hope the Chinese can improve upon some of the current product line, such as our wonderful Centricity Web viewer. As you can see in the little clip below, when you scroll through a study using the mouse wheel, you risk seizing (or wondering if there is an earthquake, which there indeed was on the East Coast today):


video

Since the US division can't seem to fix this, maybe Beijing can do something. We can only hope.

I guess Mr. Immelt has found yet another way not to pay US taxes. Maybe GE will invite ME over to the new HQ...wait...Dalai in China? Probably not.

Saturday, August 20, 2011

New iPad 3 Well-Suited For Radiology

Apple never, ever, EVER reveals details about its new products, but sometimes its suppliers are a little more loose-lipped.

The Wall Street Journal reports that Apple is buying up components to build the next generation iPad 3, due for release sometime in 2012. Most importantly:

The next generation iPad is expected to feature a high resolution display - 2048 by 1536 compared with 1024 by 768 in the iPad 2 - and Apple's suppliers have already shipped small quantities of components for the sampling of the iPad 3. Suppliers said Apple has placed orders for a 9.7-inch screen device.
BINGO! As I had hoped in my pieces about the original iPad, Apple has finally ported the Retina Screen, or something similar, to the iPad 3. Note that the resolution of the new screen is close to that of a 3MP monitor, and so at least that parameter will suffice for review of computed radiography. Of course, we don't know the luminance of the new screen (probably less than your current Barco) or the bit-depth and so on, but...

Vendors, mark my word...the iPad 3 will be THE new mobile viewing platform. Bank on it, plan for it, and be prepared with software and/or server-side products ready to handle it.  Trust me.  Have I ever let you down?


Tax Envy

Warren Buffett, the Oracle of Omaha, came out recently with a rather controversial statement:
But for those making more than $1 million — there were 236,883 such households in 2009 — I would raise rates immediately on taxable income in excess of $1 million, including, of course, dividends and capital gains. And for those who make $10 million or more — there were 8,274 in 2009 — I would suggest an additional increase in rate.

My friends and I have been coddled long enough by a billionaire-friendly Congress. It’s time for our government to get serious about shared sacrifice.
Ummm, OK. That's nice of you to offer, Warren. I wonder how many of your millionaire/billionaire friends are on the same page with you on this.

Sadly, Warren doesn't put his money where his mouth is, making him a very rich hypocrite with wonderful-sounding but ultimately empty rhetoric. David S. Logan, writing on the Tax Foundation's Tax Blog, notes:
Mr. Buffett chose to leave most of his fortune to the Bill & Melinda Gates Foundation and, thus, avoided an estate tax that could potentially give 55 percent of his wealth to Uncle Sam. Moreover, keeping that wealth actively working in the private sector would generate deficit reducing tax revenues indefinitely.
Logan goes on to deconstruct the faulty thinking behind Warren's generous offer:
  • Mr. Buffett seems to forget that capital gains and dividends taxes are a double tax on corporate income. Before it gives out a dollar in dividends, Berkshire Hathaway - like all U.S. corporations - must first pay a 35 percent federal corporate income tax, one of the highest in the world. Then, shareholders pay the individual tax rate of 15 percent on their dividend income or the gains from appreciated stock. As a result, the combined tax rate of 50 percent is the 4th highest combined dividend rate in the industrialized world. Ironically, we had the 8th highest combined rate under Bill Clinton.
  • In his op-ed, Mr. Buffett suggests that increasing taxes on the rich ensures that they pay their fair share. Perhaps, but while the top 1 percent of taxpayers earn 20 percent of the nation's income, they currently pay nearly 40 percent of the income taxes. That's a greater share of the burden than the bottom 90 percent combined (that's everyone earning under $100,000 by the way). 
  • Let's not forget that when the top marginal income tax rate was 70 percent in 1980, the rich paid 20 percent of all income taxes. Yet now, when the top marginal rate is 35 percent they pay twice that. 
  • Finally, while the tax burden on the rich has been growing, the burden on low and middle-income Americans has been shrinking. By most accounts, roughly 50 percent of American households pay no income tax at all. Indeed, the IRS will give out roughly $110 billion in "refundable" tax credits this year to households that pay no income taxes.
  • Contrary to Mr. Buffett's and President Obama's perceptions, America's wealthiest taxpayers are paying a disproportionate share of the income tax burden. Before we ask the rich to pay more, perhaps we should ask those who are paying nothing to contribute at least something to the basic cost of government.

Scott Hodge, also writing for the Tax Foundation, elaborates on the notion that the "wealthy" aren't paying enough:

  • Recently released IRS data for 2009, shows that taxpayers earning over $200,000 paid 50 percent of the $866 billion in total income taxes paid that year, or $434 billion. Skeptics will say, "That's because they earn the majority of the income in America. Not so. These taxpayers earned 25 percent of the $7.6 trillion in total adjusted gross income in the country that year.

  • The 2009 IRS data also shows that a record 58.6 million tax filers had no income tax liability that year. This means that 42 percent of the 140 million Americans who filed tax returns that year contributed nothing to the basic cost of government.
  • I have to believe the "rich" are doing more than their fair share. In fact, they are covering the nearly half of the country that pays nothing at all. How much more should they pay? Review the facts above before you answer that.

    But the nation is in dire straights, with horrendous debt, and the "rich" are holding out on us need to do their fair share to help the nation. Sadly, the United States has hemorrhaged so much money so quickly, the "rich" could not even begin to bail her out. Again from the Tax Foundation's Logan:
    So taking half of the yearly income from every person making between one and ten million dollars would only decrease the nation's debt by 1%. Even taking every last penny from every individual making more than $10 million per year would only reduce the nation's deficit by 12 percent and the debt by 2 percent. There's simply not enough wealth in the community of the rich to erase this country's problems by waving some magic tax wand.

    Finally, to put everything in perspective, think about what would need to be done to erase the federal deficit this year: After everyone making more than $200,000/year has paid taxes, the IRS would need to takeevery single penny of disposable income they have left. Such an act would raise approximately $1.53 trillion. It may be economically ruinous, but at least this proposal would actually solve the problem.
    But, we're missing something. Those to the Left of center, whose numbers include hypocritical billionaires, it seems, aren't interested in fixing anything, such as paying off the debt. Just what do they want?

    Here's one possibility:
    . . . First place aversion arises from progressives’ moral view that requires them to help everyone– you can never reduce carbon emissions enough, donate to the poor enough, elevate support minorities enough, etc– and holding themselves accountable for failing their moral obligations. And they fail all the time because progressives like nice, expensive cars, clothes, food, yoga studios, Martha’s Vineyard, etc, much too much to abide their moral world view. That moral deficiency causes them to:
    1. Appoint others who force [others to pay taxes] and contribute to ending every harm; forgiven and made worthy, they ignore that their appointees often harm the poor and force others not afflicted by First Place Aversion to pay; and 
    1. Steal and sully the poor’s lack of culpability for all the wrongs that rich progressives can’t fix by paying them off with other people’s money.

    In other words, rich progressives need to feel good about themselves, perhaps to assuage their guilt over being wealthy in the first place.  But instead of getting down and dirty themselves, they do their "good" by forcing others to cough it up.  In the meantime, they totally ignore what makes the poor, ummm, poor.

    It is beyond the scope of this post to discuss the latter issue.  Suffice it to say, in many cases (but certainly not all), those in poverty have landed there by making incredibly bad decisions.  Alcohol and drugs are big players in this, but simple lack of discipline is right up there, too. You've seen people in line at the grocery paying for food with their WIC card, while chatting away on their iPhones, wearing $200 sneakers, and draped in gold.  These people can be white, black, Hispanic, or whatever, so don't accuse me of racism. And don't accuse me of lying, either, as you've seen this, too.  These people are "poor" because they can't stop spending money on the non-necessities of life, and they have been trained by the sympathetic, hypocritical Left to expect the rest of us to cover their chit in life.

    I believe strongly in charity, in helping those who NEED help.  I tried to cast my views in the light of the Jewish approach to charity relative to the Health Care Abomination in THIS post, and my feelings haven't changed.  The approach of the Left has nothing to do with helping anyone.  It is simply a drive for power and control. It pits rich against rich and rich against poor in hopes of confiscating from the former and buying off the latter. There is no thought of raising the poor out of poverty, but rather keeping them just happy enough that they don't realize what has been done to them.

    I've heard angry Leftists rail against the "rich", with the implication that the rich got that way off the backs of the poor, and that they owe it to the poor to take care of them.  Perhaps this is true in a few situations, but these are few and far between.  Buffett himself became very wealthy by making shrewd investment decisions, evaluating the companies he bought with data available to anyone who can read, especially in this day and age of universal information brought to you via the Internet.  Who did he steal from?  No one. Why is he wailing about the low tax rates of the ultra-rich?  I guess it makes him feel better.  Old Warren may not have been the most moral fellow in his younger days, and he might think he has to make things right with God. Whatever floats his boat. But it's very hard to get around his hypocrisy. He bleats from his bully pulpit, all the while avoiding every last bit of tax possible.  If he feels so strongly about this, he could make a much more powerful statement by writing a very large check to the IRS. (If you are so inclined, go straight to Pay.gov, and give until it hurts.  Hurts YOU, that is.)

    I've noticed that Warren's Berkshire Hathaway hasn't done so well lately:


    Maybe Warren is worried about joining the ranks of the poor himself?

    Friday, August 19, 2011

    Captain Kirk Sings Cee-Lo's Song...



    Yes, that IS William Shatner's voice (mostly):




    If you haven't heard it yet, here is the incredibly talented Cee Lo Green with the original (WARNING---EXPLICIT LYRICS NOT INCLUDED! THIS IS A FAMILY BLOG!!):



    I had to get one last shot at Xtranormal's "Totally Trekkie SciFi Movie Contest" and you'll note mine is indeed the final entry. Wish me luck!

    ADDENDUM

    Well, this cartoon received an honorable mention from Xtranormal, but didn't win the contest.  It went a few seconds over the two minute limit, and "rules are rules"!  I'll do better next time.  This is what happens when you slap something together five minutes before the contest ends!!!

    Wednesday, August 17, 2011

    TabCo...er...Grid Tablets Launched!

    I recently posted about some stealthy company named Tabco with some new take on tablet computing. Like every other new product, this was supposed to be the NEXT BIG THING, rendering iPads, Galaxy Tabs, and so on to the garbage heap (as well as their lemming-like owners, according to the ad.)

    Well, as reported in Techie Buzz, it turns out that TabCo is REALLY FusionGarage, based in Singapore, and their new product line includes the Grid 10 tablet, and the Grid 4 phone. Yes, phone! These little gems utilize the new Grid OS:
    GridOS is a groundbreaking operating system that features many first-of-its-kind functionalities. It reinvents touch computing from the ground up. Its user interface is unlike anything out there. It’s a groundbreaking, visceral experience. GridOS is stunning, smart, social and transportable. It features a groundbreaking animations engine. Every feature had been rethought and made better. Web Surfing, Email, Video, Music, Photos, Home Screen Navigation and more. It’s like nothing you have experienced before and it’s what makes Grid10 an exhilarating experience.

    GridOS user interface is fresh and intuitive. Its grid layout is fluid, easy to use and unique compared to any other device. User interface innovations extend across all its functionalities. Even the way you interact with a volume dial has been rethought and delivered.

    GridOS was built leveraging an android kernel. It was built on top of Android. Similar to how Apple built Mac from Unix BSD. GridOS is highly secure and scalable.

    GridOS supports Android Apps. Android Apps runs on GridOS without requiring and redevelopment or new code. With thousands of apps available, you with never be bored with GridOS.
    One key to GridOS appears to be the reinvented wheel:
    This is no vanilla UI. It fundamentally changes the way you will experience a tablet. Completely gesture-based and button-free, Grid10 lets you navigate naturally, easier and without restriction. We’ve even eliminated the boring slide bar to access Grid10. You sign on – literally – with your signature. Sounds like we have reinvented the wheel, doesn’t it? Well, we have with our wheel-based interaction. A finger tap brings up the wheel and its spokes offer a multitude of functions. Just slide your finger around the wheel and choose the desired function.


    I might have chosen another example than Lady Gag Gag, but you get the idea.

    The Grid10 is a nice-looking monolithic slab with a 10-inch screen:

    Under the hood, or screen, or whatever, it's pretty advanced for a tablet (from Techie Buzz):
    Some other technical aspects of note is that it packs a Nvidia Tegra II 1.2Ghz Dual Core processor, 512MB RAM, and 16GB of storage. It runs on the GridOS. It is Wi-Fi and 3G capable. It has a front facing camera that will work with its video calling feature that boasts one to one, and one to many, video calls. It also allows for HDMI connectivity.
    More specs here. The WiFi version is $499, and the 3G (no 4G, I guess) is $599.

    The Grid4 phone looks like a squared off version of the iPhone 4, but with no home-button:

    FusionGarage is rather proud of the minimalist design:
    It will be hard to look away from a Grid4. It’s amazingly sexy. It’s amazingly sleek. There are no buttons. There are no curves. Its just 4 inches of all screen. The straight edges scream simplicity. It’s a triumph of honest design. The all-aluminum back is a nice touch. It’s shaped around the function with no artificial design. You will turn heads with a Grid4 in your hands.
    The 4 inch screen has resolution of 800x480 pixels, as compared to the iPhone 4's 960x640 pixels on its 3.6 inch diagonal screen. Sorry, Verizon-lovers; the Grid4 has a quadband GSM chipset.

    In rather amusing fashion, all the accessories, such as the adapter plug below, are done up in Grid Red:


    Are the Grids iPad/iPhone killers? Hard to say at this point. Frankly, based on the very limited views on the FusionGarage website, they have more potential to be Android killers. They seem to build nicely upon the Android kernel, with what seems to be a far more pleasing interface. But the market will decide.

    If this all sounds a bit familiar, you may be remembering the last production from FusionGarage, the rather unfortunately-named Joo-Joo, which was formerly known as the Crunchpad. It ran Linux, and barely saw the light of day. I expect FusionGarage will have significantly more success with the Grids. Seems to me they will appeal to those who don't want to give Apple (and Steve Jobs) their due, but are looking for something beyond the Androids.

    I would love to hear from any bleeding edgers who've actually purchased one of these things...

    Tuesday, August 16, 2011

    My Big Fat Greek Vacation



    My loyal readers have no doubt noticed a paucity of postings here on the blog. There are several reasons for this:

    1. I'm tired and lazy
    2. I was in Greece with my family for part of July
    3. It's hot here (and in Greece)
    4. We're trying to get Dalai, Jr., to work on his college applications, and the daily whippings take a lot out of me
    Most of these are self-explanatory. The trip to Greece had been planned for the better part of a year, but was almost scuttled by the troubles reported over there, mainly in Athens. However, we never saw a hint of riots or other nastiness, although most of the shopkeepers, and the captain of our little boat, were rather disheartened by the whole economic situation, and blamed Germany for charging Greece 7% interest when everyone else gets 3%. Apparently the concept of being a bad risk doesn't translate well. But life goes on over there, and the Greeks seem proud and happy none-the-less. Personally, I would be depressed at paying over $10 for a gallon of gas, but they seem to be used to such things. 

    I would post more photos, but our group had five cameras going more or less simultaneously, which produced well over 3,500 images, so it will take a good while to pare all that down to a usable level. 

    Anyway, be prepared for more PACS news. If there's a topic you feel deserves attention, or if you've heard something especially juicy, please drop me a line at doctordalai(AT)gmail.com.

    Ευχαριστώ!!

    Sunday, August 07, 2011

    Thursday, August 04, 2011

    TabCo?


    Attention tablet users!  Apparently, you are all a bunch of lemmings, satisfied with the mediocre performance of the available devices, iPads, Galaxy Tabs, and so on.

    Enter TabCo.  Here's what I know about them:  NOTHING.

    Here's what All Things D knows about them:  (Hint:  not much...):
    The big reveal for TabCo is set for Aug. 15, but AllThingsD has managed to gather a few facts on the company’s forthcoming product.

    On the hardware side, TabCo’s product will have many of the usual features, including Wi-Fi and optional 3G connectivity, support for Bluetooth and USB, as well as its own suite of apps for editing and viewing documents, photos and videos.

    The big thing that sets it apart, I’m told, is its software and what insiders call a “predictive user interface.” The design is said to anticipate user needs to help perform tasks such as Web searches, buying products or getting directions.
    OK, I'm intrigued, but we've all been disappointed before, as ATD notes:
    I can say that the company is playing a high-risk game with all of its antics. Such activities can — and have — built buzz for new technologies even before anything is known about the actual product. That said, such pitches often spin out of hand, with the hype building so much that the eventual product can hardly help but fail to meet expectations.

    Microsoft tried such an approach in the middle of last decade with Project Origami, which was later revealed to be a pricey handheld touch computer. Though in many ways aprecursor to the iPad, the initial batch of Origami devices were too expensive, hard to manipulate via only one’s fingers, and had embarrassingly short battery life.

    Perhaps because the Origami devices were so far short of expectations, Microsoft essentially dropped the project rather than continue to iterate and plug away — a decision that the company might be regretting after seeing Apple enjoy the riches from a tablet market that Microsoft spent years working to create.

    The Segway, too, was built up to legendary proportions before it was revealed, with leaks suggesting that luminaries like Jeff Bezos and Steve Jobs believed the product could change the world and cause cities to be designed differently. In the end, the Segway proved to be a niche success, at best, as a platform for security guards, mail carriers and tourists looking for a unique way to see the sights.

    So, TabCo — or whoever you are — you’ve got our attention. Now it’s up to you to deliver something that keeps it.
    We'll be watching.  8.15.11.  At least it's not set for 4.1.12....

    Tuesday, August 02, 2011

    The End Of An Era


    Everyone who is anyone in the PACS business knows Mike Cannavo, the One and Only PACSMan.  I'm very sorry to report that the PACSMan is no longer with us.  But don't grieve...Mike is still alive and well.  He simply had to move on to greener pastures, given the current economic troubles with PACS and everything else, leaving the PACSMan entity behind.  Mike posted this message to AuntMinnie's PACS forum:

    After 28 wonderful years it’s time for the PACSMan to finally hang up his shingle and just become just plain Mike again. It’s been a blast but change is necessary for growth and my life is changing in so many ways.

    My sons have grown into wonderful young men, men I am exceptionally proud of, and my role as a dad has slowly evolved over the past few years. I am now more of a confidant and mentor than taskmaster and taxi driver. Soon, all too soon, my house will be emptier as my baby heads to Rhodes College in Memphis to start college. My oldest attends college locally and still lives at home but between school and work (both at the Apple store and as a top notch web-site developer) I don’t see him nearly as often as I used to either. So it’s really just me and Elvis, the world’s wackiest beagle, and sadly soon he too will no doubt be headed down the road to a new home since my new job requires a bit of travel.

    New job? Yes, after years of being on my own I have indeed elected to join the racks of the steadily employed and it’s not heading up Merge or Iron Mountain either . I have loved being a PACS consultant- no position could have been better given the requirements I had when my kids were growing up- but the position I was recently offered allows me to help more than just a handful of clients a year. That is very important to me- sharing the knowledge- just as it has been over the past several decades in the 350+ articles I’ve written and in the countless presentations and Webinars I’ve given. I have been given the chance to take on a phenomenal position in a phenomenal company with a phenomenal leadership team and frankly it’s just too good to turn down. So it’s my turn now.

    Know I am really going nowhere and will still be very actively involved in the radiology community, just not as the PACSMan. . . I’ll probably change the blog title to something like “Confessions of an Ex-Altar Boy” or something equally reverent. You will also see my comments in the PDF now and then but under a different moniker. And who knows, someday the PACSMan might indeed make his triumphant return, probably doing it just like Jesus did by riding in on a donkey to Jerusalem, but instead my riding onto the floor of the RSNA on one instead . We’ll just have to see what the future brings.

    To Brian Casey, Erik Ridley and rest of the AuntMinnie staff, thank you for giving me to the chance to share what I have learned over the years with our readers. To the AM readers, thank you for making my articles number one each time they were published, and especially the ever politically-correct PACSMan Awards® which I will miss writing more than anything else I’ve ever done. To my clients, end-users and vendors alike, you are the very best and your kindness and support will never ever be forgotten.

    When my son graduated high school a month or so back (Summa Cum Laude no less) it was a bittersweet moment for me. It signaled that my role as a dad was pretty much over. I’m still not sure how to deal with that- empty nest is hitting me a lot harder than I ever expected- but Matt’s class motto put things in its proper perspective for me. The saying is attributed to Dr Seuss and goes “Don’t cry because it’s over, smile because it happened.” And so that is what I will do and hope you will as well.

    Thanks for 28 years of smiles. Until we meet again I remain.

    Mike Cannavo- The One and ONLY PACSMan
    Well, there you have it.

    I've been in communication with Mike since 2003, when I first started dabbling heavily in the PACS field as a semi-educated consumer.  Our corresponding friendship started with my wondering how to handle some nasty trolls who were attacking me on the PACS forum.  Mike responded:
    A lot of these folks making the postings suffer from a disease known as LDS, and I'm not talking about the The Church of Jesus Christ of the Latter Day Saints either. It's Little D*ck Syndrome- where you have to make up for your "shortcomings" somehow so you mock on the first person who seems to know what the hell they are talking about. I live it every day.
    Classic Mike.

    I'm expecting him to keep his promise, and appear to us in unexpected ways, be it on a new blog or in some clever new persona on AuntMinnie.  In the meantime, if you want to know the Mike I know, head to his blogsite before it goes away- http://thepacsmanpontificates.blogspot.com/. We share a lot more in common than most would imagine. Mainly our warped sense of humor and love of filet.

    But maybe, just MAYBE, the annual PACSMan awards can morph into the DoctorDalai awards?  Would anyone mind very much?

    Godspeed in your new career, Mike!