Towards social radiology as an information infrastructure: reconciling the local with the global.

The current widespread use of medical images and imaging procedures in clinical practice and patient diagnosis has brought about an increase in the demand for sharing medical imaging studies among health professionals in an easy and effective manner. This article reveals the existence of a polarization between the local and global demands for radiology practice. While there are no major barriers for sharing such studies, when access is made from a (local) picture archive and communication system (PACS) within the domain of a healthcare organization, there are a number of impediments for sharing studies among health professionals on a global scale. Social radiology as an information infrastructure involves the notion of a shared infrastructure as a public good, affording a social space where people, organizations and technical components may spontaneously form associations in order to share clinical information linked to patient care and radiology practice. This article shows however, that such polarization establishes a tension between local and global demands, which hinders the emergence of social radiology as an information infrastructure. Based on an analysis of the social space for radiology practice, the present article has observed that this tension persists due to the inertia of a locally installed base in radiology departments, for which common teleradiology models are not truly capable of reorganizing as a global social space for radiology practice. Reconciling the local with the global signifies integrating PACS and teleradiology into an evolving, secure, heterogeneous, shared, open information infrastructure where the conceptual boundaries between (local) PACS and (global) teleradiology are transparent, signaling the emergence of social radiology as an information infrastructure.