The adoption of innovation.

As a field, radiology is critically dependent on innovation. This discipline was born with Roentgen’s discovery of x-rays, and it has been repeatedly renewed and even revolutionized by the introduction of new imaging technologies, such as ultrasonography (US), computed tomography (CT), magnetic resonance imaging, and positron emission tomography. Thanks to such innovations, radiologists have played a progressively greater role in patient care. The role of radiology in medicine has become so great that it is now difficult to imagine the practice of most clinical medical specialties without it. Because radiology relies so heavily on continuous innovation, it is vital that radiologists possess a thorough understanding of the subject. Practically speaking, innovation has two components: the development of new technologies and their adoption into clinical practice. Both components are necessary if innovation is to make a difference. One of the most important scholars of innovation theory in the latter half of the 20th century was Everett Rogers, who was born in 1931 and died in 2004. A faculty member for many years at the University of New Mexico, Rogers grew up on a farm in Iowa and eventually earned a PhD degree from the University of Iowa. Intrigued by the remarkably different rates at which farmers adopted new agricultural products and technologies, Rogers developed a theory that he called the diffusion of innovations, which divided people into the following groups: innovators, early adopters, early majority, late majority, and laggards. He plotted the rate of adoption of innovations on a graph, which produced an S-shaped or sigmoid curve. Although Rogers published many articles and books, his work is summarized in his book, Diffusion of Innovations, which is now in its fifth edition (2). To understand the adoption of innovations, it is first necessary to identify the relevant stakeholders. In radiologic innovation, key stakeholders include patients and their families; health care providers, such as physicians, nurses, and technologists; health care payers, such as government and private insurers; vendors who research, develop, and market the technology; and policy makers and regulators. Proponents of a new technology who consider only one group of stakeholders are less likely to succeed than those who take into account all parties. For example, it is possible to convince patients to adopt a new technology; however, if referring physicians or health care payers are not committed, the innovation is unlikely to be adopted quickly, and it may not be adopted at all. Rogers described five key elements that govern the rate at which an innovation is adopted. These elements are relative advantage, compatibility, complexity, trialability, and observability. Relative advantage refers to the degree to which a new technology is seen as superior to the technology already in use. Compatibility concerns the degree to which the innovation is consistent with adopters’ preexisting values and experiences. Complexity concerns how easy or difficult it is to understand and use the innovation. Trialability is the degree to which the innovation can be experimented with on a limited basis. Observability refers to the conspicuity of the innovation to other potential adopters. To maximize the rate of adoption, an innovation needs to offer a Published online 10.1148/radiol.2463061859