My Turn: Embracing Change And Innovation

Radiology can move health care forward by embracing new knowledge and adopting early change

Matthew A. Mauro, MD
Matthew A. Mauro, MD, is the RSNA president. Dr. Mauro is president of University of North Carolina (UNC) Faculty Physicians and senior physician executive of UNC Health Care System Revenue Cycle. He is the James H. Scatliff Distinguished Professor of Radiology, as well as a professor of surgery at the UNC School of Medicine in Chapel Hill. He has been a faculty member at UNC since 1982.

Change, as we all know, is inevitable. Radiology has long led medicine in showing how we can embrace change by seeking innovation. As the pace of change rapidly accelerates, our leadership in driving health care innovation has become ever more important. We are experiencing transformations in our clinical knowledge base and technological capacities, as well as in modes of health care delivery and practice management. Radiology remains well poised to continue its leadership in moving health care forward across all of these domains.

Beginning with Roentgen’s discovery of the X-ray in 1895, our field has grown, developed and evolved through transformational innovations that have changed the landscape of medicine and the lives of countless patients: ultrasound, computed tomography, magnetic resonance imaging, molecular imaging and image-guided interventions. Now we have seen the digital revolution and the introduction of AI disrupt the specialty – and all of medicine – once again. All of these technical advances undoubtably continue to require us both to drive and adapt to major changes in our discipline.

Innovation is defined simply as the introduction of something new. In health care, this might be an idea, method, drug, device or procedure. Innovation is the cornerstone of both diagnostic and interventional radiology (IR). For example, the Seldinger Technique, described in 1953, was the catalyst that spawned the development of an entire specialty. Innovation is an evolutionary process, usually occurring over five stages. It all begins with an idea. This initial idea must be enhanced through advocacy and development, and vetted through experimentation (animal models, human trials). Not all ideas are viable; in fact, most ideas dissipate within these three initial stages. For those that continue, the next stage is commercialization, including regulatory approval, reimbursement and production. This is often the most challenging stage and requires a shift in approach from development to persuasion, creating demand for the product. The fifth and final stage is diffusion and implementation. This is the point at which radiologists must embrace the new development.

The diffusion process by which innovation is disseminated and embraced over time was defined by sociologist Everett Rogers. In his model, only 2.5% are innovators—the brave ones who push change forward. Early adopters (13.5%) are opinion leaders who will try new ideas but cautiously. The early majority (34%) are thoughtful and careful but willing to accept change more quickly than the average, whereas the late majority (34%) tend to be more skeptical and wait to see what others do before embracing change. The last group are the laggards (16%). They tend to be traditionalists who value the old ways and may be hypercritical of new ideas. They accept innovations only when forced to do so.

Radiology’s historical embracement of technological and operational advancements has positioned our discipline at the cutting edge of medical transformation. Radiology’s continued ability to embrace today’s emerging innovations and advocate for their early adoption into mainstream medicine will be critical for our continued success and growth.

Presently, many other disciplines are entering into the image interpretation and image-guided intervention arenas. Radiologists are no longer guaranteed exclusivity for image interpretation based on our board certification. This is why our striving for excellence in interpretive skills, staying current in clinical knowledge, and remaining primary drivers of innovation are more critical than ever.

RSNA will remain the centerpiece of science and education for radiology. Embracing new knowledge and remaining ready to adopt change early will provide a strong foundation for our continued success as essential members of our local and global health care ecosystems.