Dr. Ruth E. Dayhoff

I had been interested for a long time in the use of computers in medicine. I felt that by bringing a technology into medicine that could be used by many, many doctors, I could make a bigger difference than I would as a single practicing physician. It was difficult because I had to actually persuade people that computers were important, and that they needed a physician to help them with medical computing—that I wasn’t just a programmer. I also had a job working on medical databases, the sorts of databases that would hold patients’ information. And I began to think that wouldn’t it be wonderful if we could combine both the database technology and the image technology into one system, so that you wouldn’t have to store your images on tapes with labels, or on disks, that you couldn’t find what you needed, that it would be linked together. You’d just check the database and it would show you the image. So this idea further developed when I visited the VA (Veterans Affairs) Medical Center and the doctors looked at the system and said, “Wow, this would really help us in the hospital.” So that was the beginning of the VISTA Imaging Project. The VISTA Imaging System is an integrated computer system that combines images with patient records in an online system. The software runs on workstations throughout the medical center, providing physicians with the information that they need to treat their patients. And it’s actually running in over a hundred hospitals across the country today. They started using the system on the wards. When they were treating a patient they found that by looking at an image, they had a sense of the urgency. For instance, if they saw a vessel in the heart that was 90 percent occluded, 90 percent didn’t tell them very much. But when they saw the image they could realize the impact that the problem was having on the patient. They could even show the image to the patient and explain to them what the problem was, then let the patient be part of the decision making process. So they were really very enthusiastic about it. It was very important to work with people who were taking the system and putting it into their process of practicing medicine, and in some cases changing the process to take advantage of the technology. And that’s really what we want to do, bringing the technology to medicine.