The Diffusion of Magnetic Resonance Imaging Scanners in a Changing U.S. Health Care Environment

Abstract

Technological aspects and early clinical experiences are arousing great enthusiasm over magnetic resonance imaging (MRI). However, influences such as regulation, reimbursement, and increasing competition also are playing important roles in determining the diffusion of this new technology. Of these considerations, competition among providers seems the most important. Competition related to MRI is manifested as direct competition over MRI services, using MRI to improve a provider's strategic position and competition among specialties. In making decisions concerning MRI acquisition and operation, providers are drawing upon their experiences with computed tomography (CT) to help them determine when would be the best time for acquisition, how to decide whether acquisition is appropriate, and how best to acquire, operate, and market the technology.

The Diffusion of New Imaging Technologies: A Molecular Imaging Prospective

“…In the past, opinion leaders wishing to be early acquirers have often posed the possibility of obtaining a competitive advantage as a rationale for assuming this risk. They properly argue that with medical technology, there is often a "first-mover advantage" [9]. By this they mean that a provider might gain organizational experience, name recognition, and a reputation for special expertise that will be hard for regional competitors to supersede when they later acquire the technology.…”

“…For the reasons noted in the above paragraph, early acquisition has been a successful strategy for such previous imaging technologies as MRI [7,[9][10][11]. Nonetheless, there are some differences between molecular imaging and such technologies as MRI that might determine a different outcome.…”

The Role of Hospital and Market Characteristics in Invasive Cardiac Service Diffusion

“…For example, Robinson and Luft (1985) characterized new service adoption as the result of a medical arms race, one that leads to inefficient investment in medical technology. Scholars later found evidence that the acquisition of new medical technology was driven by, among other factors, a hospital's attempt to maintain or expand a local market (Hillman et al, 1987) and the importance a hospital attaches to being a technological leader (Teplensky et al, 1995). Skinner & Staiger (2015, pg. 3) made progress in reconciling these views-that technology adoption led to improvements in health and that technology adoption was caused by, at least in part, nonmedical reasons-in arguing that health care "improvements are largely associated with the adoption of effective treatments, rather than more factor inputs per se.…”

Translating Molecular Imaging Research into Radiologic Practice: Summary of the Proceedings of the American College of Radiology Colloquium, April 22–24, 2001

“…To some extent, departments wishing early involvement in molecular im-aging can gain entrance at lower cost by focusing on rodent imaging. 6. Institutions most likely to be successful in establishing research programs are ones with a successful history in research and a diverse array of research resources at their institution outside of radiology.…”

“…In the classical literature on the diffusion of medical technology, it is said that major innovations progressively diffuse from major academic medical centers to university-affiliated hospitals to community hospitals to outpatient centers and office practices and from urban to rural. However, studies of MR imaging showed a very different pattern of diffusion based on the medical economic environment of the times (5)(6)(7). Specifically, along with regulation, competition among providers played a major role in promoting the acquisition of MR imagers among atypical providers who either would ordinarily be expected to acquire technology later in the diffusion process or who had not previously been involved in medical imaging.…”