The data that will be stored in these electronic health records can tell how molecular imaging can differentiate helpful from unhelpful care. It will help eliminate costly, unhelpful care and therefore more care can be provided to more people because you will be doing it much more efficiency per patient.

[DM: How does the field of nuclear medicine stand to benefit?]


HW: The new reforms are going to help nuclear medicine if properly used, not the way they are proposing. What you read about are things like patient scheduling and transfer of records from one hospital to another. What I am saying is that recording and analyzing the data from these patients will really improve patient care and decrease costs.

You can do what's called data mining, take all this data and mine it for what helps and what doesn't help and change practice patterns.

For example there are nuclear imaging studies that show that coronary angiography could have been avoided. The University Hospital of Zurich [BA Herzog et al] showed that in a large series of patients where they did both invasive coronary angiography and the SPECT studies that they could have avoided the coronary angiography in 60 percent of the patients, which is a great savings in cost.

[DM: Now you are speaking the government's, or the payors', language]

HW: Medicine can be divided into research, clinical and the economic. The economic is coming to the forefront right now. It really puts nuclear medicine into a tremendously important position. There are millions of studies being done but billions of patients being treated so [our understanding] will expand from the millions to the billions [if we implement and mine electronic records]. Those types of studies are what nuclear medicine is doing very well right now.

[DM: What about the promise of genetics? Is your field in the position to fulfill that promise?]

HW: Genetics was over-hyped. It is extremely useful but was oversold. An enormous amount of effort has gone into it but produced some less than useful stuff so far. The combination of phenotype measuring, where you measure how genes express themselves in the manifestations of diseases, will greatly improve the field of genomics. But genomics has been somewhat disappointing in its clinical application.

I would say that the measurement of phenotypes, which is what we do in molecular imaging, will help fit genomics better into the health care system.

[DM: What are some other examples of how electronic records will synch will molecular imaging or some other real clinical application to improve health care delivery?]

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