January 1, 2017, is likely to be a red-letter day for radiology. As of this date, physicians ordering advanced diagnostic imaging exams (CT, MRI, nuclear medicine, and PET) for Medicare beneficiaries must, in compliance with the Protecting Access to Medicare Act of 2014, consult government-approved, evidence-based appropriate use criteria through a clinical decision support (CDS) system.

Riverside Radiology and Interventional Associates (RRIA), Columbus, Ohio, was an early pioneer in the transition from analog to digital radiology, and radiologist Peter Lafferty, MD, vividly recalls his first encounter with the interpretation of digital images in the late ‘90s.

The question in the headline is not open-ended and philosophical. It is multiple-choice and strategic, as any given hospital or multi-hospital system now inevitably perceives its contracted radiology practices as occupying ground in one of only three possible capacities.

We’re only halfway through the current calendar year, and already radiology practice in the U.S. has been jolted by not one but two major transactions.

When it comes to diagnosing cancer, radiologists examine digital images and pathologists scrutinize slides. Only occasionally do the two collaborate prior to meetings of the tumor board or multidisciplinary team (MDT).

When working at a high volume breast imaging provider, radiologists can’t afford speed bumps. But hiccups in workflow are inevitable when a radiologist is forced to constantly switch between different workstations, each with their own interfaces and controls.

Apple used to push the world to “think different.” Today, the profession of radiology is being driven to think differentiation. And the impetus is issuing not from a single corporation, but rather from myriad market forces—from commoditization to consolidation to, perhaps most pressingly, ever-narrowing profit margins.

Through the exceptionally tight partnership of vRad Chief Medical Officer, Ben Strong, MD, and Chief Information Officer, Shannon Werb—explored in Part I of this interview—vRad has achieved a synergistic melding of those concepts that truly are driving clinical innovation, as evidenced by the discussion with Strong and Werb.