Managing Scale and Innovation in Health IT.

Given the high-intensity interaction between radiology and IT, radiology leadership should understand IT's new, somewhat conflicting, dual roles. Managing large-scale and small-scale projects concurrently has become an important challenge for leaders of health IT (HIT). Historical parallels of this challenge can be drawn from transportation and communication systems, in which a large-scale mind-set is needed to build the initial network, whereas a small-scale mind-set is more useful to develop the content that will traverse this network. Innovation and creativity is a cornerstone of content small-scale thinking, and in HIT, that is what is needed to extract the value from it. However, unlike the early historical transportation and communication examples, the time between the development of the infrastructure and the follow-on, value-rich content is shortened greatly because it has become nearly simultaneous in HIT. Weaving the ability to concomitantly manage both large- and small-scale projects into the fabric of the organizational HIT culture will be critical for its success.