9 questions radiology practices should ask when pursuing ‘disruptive innovation’
CHAMPIONSGATE, Fla. — A noted business strategist and futurist is offering nine key questions radiology practices must consider when seeking to innovate in 2026.
Kaihan Krippendorff, MBA, spoke on Sunday during the opening keynote of the Radiology Business Management Association’s annual meeting in Orlando. He is a best-selling author and founder of Outthinker Networks, a global think tank of chief strategy, innovation, growth and transformation officers.
Krippendorff has counseled notable companies such as Aetna-CVS, JP Morgan, Lockheed Martin and IBM, with his work helping them create over $3 billion in new annual recurring revenue. During his talk, he discussed the idea of “disruptive innovation” and creating more “fourth options” that target a segment of the market people aren’t paying attention to.
“Three,” he noted, is typically the point at which people feel they have enough choices to consider—the answer is A, B or C and nothing else.
“It means that they’ve stopped looking for new options. They’ve lost that curiosity. The sense of possibility that there could be a better way,” Krippendorff told attendees April 12. “And what innovators do is they recognize those moments, and they introduce or explore fourth options.”
In his previous work, Krippendorff has discussed examples of fourth options provided by leading companies. Walmart, for instance, built stores in rural America when the common wisdom was to target cities with adequate street traffic. Apple focused on design and aesthetics when other computer companies were targeting performance. And Tesla started offering high-performance electric vehicles when the industry was convinced EVs needed to start at the low end of the market.
Krippendorff offered nine questions that radiology leaders should consider as they search for “fourth options” to target, all starting with the letter P. Here they are in his own words:
1. Positioning: Which patient populations and service lines do we prioritize—and where do we choose not to compete? As Al commoditizes basic reads, the practices that win will have a clear answer to: Who are we really for?
2. Product/Service: Are we a scan provider or a diagnostic intelligence partner? Radiology's product is shifting from images to insights, and practices that lead on clinical outcomes will be best positioned for value-based reimbursement.
3. Placement: Where and how do patients and referring physicians access our services? As teleradiology and portable imaging expand, practices must choose their access model intentionally—not default to what they've always done.
4. Pricing (Reimbursement): How do we optimize our payer mix and build service lines that justify value beyond eroding Medicare fee schedules? Reimbursement strategy means reducing dependence on rates we can't control.
5. Promotion: How do we deepen referral relationships and attract patients directly? Practices can no longer assume relationships are permanent. Differentiated outreach matters more than ever.
6. Physical Experience: Where does our patient experience—from scheduling through results—fall short of what patients now expect? In a world where people compare us to Amazon, long waits and delayed results are a competitive vulnerability.
7. Processes: Where do our clinical and administrative workflows slow us down? Al and automation can reduce turnaround times and administrative burden, but only if we're willing to redesign how we work.
8. People: How do we recruit and retain talent—and redefine roles as Al takes on more of the traditional workflow? Defining what humans do best, and building culture around that, is the people challenge of this decade.
9. Purpose: Does our practice stand for something beyond producing reads? A clear mission—a patient population, a community commitment—is increasingly a differentiator for attracting talent, partnerships, and loyalty.
Krippendorff included his questions as part of a three-step processes toward disruptive innovation. The steps include (1) using the nine questions to help pick a leverage point in your business, (2) generating options based on your answers, and then (3) making space to work on these seemingly “crazy ideas.
“Introduce something that that someone thinks is impossible because it’s inconsistent with what they know, and as a result of that they don’t fight us,” Krippendorff said. “By the time they wake up and say, ‘Wait a second, that thing that’s happening over there is actually working,’ it’s too late. We’ve already won.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.