The evolution of radiology through product and process innovation

Grounded in visual perception and observation, the tools and techniques used by radiologist are used for both screening and diagnostic purposes throughout the continuum of patient care. Despite the overwhelmingly positive impact that-radiology has played in just over a century, the medical specialty is facing significant challenges such as declining reimbursements and an avalanche of new imaging data. The basic challenge to increase productivity and reduce costs is not necessarily new. In fact, scholars have long observed patterns of successful innovation that contribute to the pace, direction, and progress of many industries. This thesis explores the evolution of radiology through product and process innovation. Special attention is given to the role of labor and equipment specialization in reducing the number of steps while increasing productivity. An analysis of contemporary industry indicators such as residency program application rates and image volumes is presented in order to better understand the current climate of radiology. The goal of this study is to shed light on where the industry has come and where it stands, in order to provide clinicians, engineers, managers and entrepreneurs alike with action ideas to help bring in a new era in radiology. Acknowledgements This thesis marks the end of my journey at MIT and the manifestation of another. It has been an absolute privilege to work alongside so many talented individuals both at MIT and throughout the Boston Community. While I'm excited and optimistic for the opportunities that lie ahead, I owe a huge debt of gratitude to the many people who have helped me to reach this juncture. A heartfelt thank you goes to Professor James Utterback, whom I have learned so much from through the completion of this work. You are always able to challenge me in a gentle yet persuasive way helping me to think differently about a problem while keeping me on track. It has been a tremendous pleasure and honor to be able to learn from you. Thank you. My appreciation extends to the MIT Hacking Medicine community: Shirlene Liew, Christopher Lee, Lina Colucci, Hari Iyer, Priya Garg, Tatyana Gubin, Andrea Ippolito, Allison Yost, Aartik Sarma, Monica Stanciu, Katerina Mantzavinou, Bryan Ranger, Nalini Singh, Khalil Ramadi, Kristie Chung, Molly Binder, Ned McCague, Babak Movassaghi, and Judy Wang to name a few. It has truly been a pleasure to work with all of you, thesis related or otherwise. Thank you for making my experience at MIT incredible. I'm truly grateful to be a member of this humble and inspiring team. This appreciation also extends to MIT Hacking Medicine faculty advisor Zen Chu for his early guidance in the formation of this thesis. To my friends, classmates, and instructors in SDM thank you for sharing with me in this incredible journey of learning and personal development. A special thank you to the SDM program director Patrick Hale and Industry Co-director Joan Rubin. Thank you for opening the door to me and for allowing me to be a member of the SDM community, I'm grateful for your relentless advocacy for the program and the support provided to its students. I'm grateful to Garry Choy and Synho Do of MGH for their wholehearted support throughout this endeavor; your perspective and insights are invaluable. This appreciation extends to former work colleagues Hrishikesh Haldankar, Sergei Fotin, Jonathan Go, and Rick Ortega for your friendship, mentorship and expertise. I'd also like to thank friend and co-conspirator Nathan Vanhoose for years of friendship and support. Last, but certainly not least; I'd like to thank my family. Thank you to my fiancee Fadwa Constandinidis for her patience, moral support and the occasional pizza deliveries. Thank you to my siblings Andy Revelos and Christy Schaffner (Revelos) for your unconditional love and support. And lastly to my parents Lynne and Jim Revelos, whom I'm incredibly blessed to have as both parents and role models. You taught me that a strong work ethic is the key to success, all the while making countless sacrifices to ensure that we enjoyed a happy and healthy upbringing filled with great opportunities. I'm eternally grateful for your endless generosity and unwavering support. THIS PAGE INTENTIONALLY LEFT BLANK Table of