ari - theory and application

Technological Forecasting & Social Change xxx (2008) xxx–xxx

TFS-17084; No of Pages 13

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Technological Forecasting & Social Change

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Technical Note

Accelerated radical innovation: Theory and application

John A. Bers a,⁎, John P. Dismukes b,1, Lawrence K. Miller b,2, Aleksey Dubrovensky b,3

a Vanderbilt University School of Engineering Featheringill Hall Room 336 P.O. Box 351518 Station B Nashville, TN 37235, USAb Chemical and Environmental Engineering Department Director, International Accelerated Radical Innovation (ARI) Institute College of Engineering The University ofToledo, 2801 West Bancroft Street NI 3064 MS 305 Toledo, Ohio 43606-3390, USAc Electrical Engineering and Computer Science Associate Director of the Manufacturing Value Chain Science (MVCS) Center College of Engineering The University ofToledo 2801 West Bancroft Street NI 3064 MS 305 Toledo, Ohio 43606-3390, USAc 7900 Stonydale Lane Louisville, KY 40220, USA

a r t i c l e i n f o

⁎ Corresponding author. Tel.: +1 615 343 4965; fax:E-mail addresses: [email protected] (J.A.

[email protected] (A. DubroURL: http://mot.vuse.vanderbilt.edu, http://eecsm

1 Tel.: +1 419 530 8065.2 Tel.: +1 419 530 8193.3 Tel.: +1 502 777 0816.

0040-1625/$ – see front matter © 2008 Elsevier Inc.doi:10.1016/j.techfore.2008.08.013

Please cite this article as: J.A. Bers, et al., ASocial Change (2008), doi:10.1016/j.techfo

a b s t r a c t

Article history:Received 30 January 2008Revised 16 June 2008Accepted 1 August 2008Available online xxxx

Radical innovation has been responsible for some of society's greatest advances over the pasthundred years in fields as diverse as transportation, power, information technology, andmedicine. But as scholars have found, it is such a long-term, chaotic, meandering, unpredictableprocess that promising radical innovation concepts are often never undertaken, to society'sdetriment. Does it need to be this way? Or can radical innovation be accelerated so that it ismanageable within modern society's economic and political time horizon? This questionprompted the organization of the Accelerated Radical Innovation (ARI) project five years ago. Inthis paper we summarize the ARI methodology as it currently stands and then report the resultsof an empirical verification with a radical medical innovation project that is currently underway — monochromatic X-rays for cancer diagnosis and treatment. Several conclusions weredrawn. First, by and large, the ARI model tracked closely with the reality of this innovation,offering confirmation of its grounding in the real world of innovation. Second, the modeloffered a rationale and framework for this innovation process that could be more widelyadopted. Third, the ARI model exposed critical issues whose early resolution could haveaccelerating the innovation cycle. Fourth, the application of a core principle of ARI, SystematicCompetitive Intelligence, could have provided early warning on a competing technology thatemerged suddenly. Last, the use of another core ARI concept, accelerated innovationprototyping, might help the innovator overcome the key barrier facing the innovation — thenecessity of a long, expensive, high-risk clinical trial. Overall, the verification study confirms thepotential of the ARI model to put the radical innovation process on a faster, lower-cost, better-managed track.

© 2008 Elsevier Inc. All rights reserved.

1. Introduction — why do we need to accelerate radical innovation?

Radical innovation — innovation that creates an entirely new set of performance features; improvements in knownperformance features of five times or greater; or a significant (30% or greater) reduction in cost [1]— has been responsible for someof society's greatest advances over the past hundred years in fields as diverse as transportation, power, information technology,

+1 615 322 7062.Bers), [email protected] (J.P. Dismukes), [email protected] (L.K. Miller),vensky).ail.vuse.vanderbilt.edu/exchweb/bin/redir.asp?URL=http://mot.vuse.vanderbilt.edu (J.A. Bers).

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ccelerated radical innovation: Theory and application, Technological Forecasting &re.2008.08.013

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http://mot.vuse.vanderbilt.edu

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and medicine. Yet, if you were to take your next radical innovation concept to your company's board of directors, or to a roomful ofventure capitalists, you’re likely to get the cold shoulder.

Why? In a nutshell, there are too many safer, surer, less costly, nearer-term bets — why take a chance on you! With the timehorizon for mostWestern business executives and politicians being the next election, the next annual report, or the CEO's expectedtenure (median of 7.8 years globally [2], four years for S&P 500 CEOs [3]), it is understandable that the term “radical innovation” hasbecome radioactive in many executive suites, and truly promising breakthroughs that require a decade or two of developmentbefore their benefits are seen are often swept aside for projects with shorter term benefits. Society as a whole is poorer becauseinnovations that could alleviate major societal problems or create capital are left aside.

As scholars of MOT have known for decades, radical innovations give rise to technological revolutions. These revolutions occurin cycles, and the cycles can last for several decades [4–8]. Those who have studied radical innovations have been struck by howunplanned (serendipitous) they have been, the length of time between initial technical or scientific breakthroughs and commercialrealization, and the meandering course of their development [1]. A major reasonwhy these cycles are so drawn out is that much ofradical innovation is also disruptive — to existing markets, widely held social values, user behaviors, and ingrained organizationalbehaviors. And those were the successes! [7,9]

Is this inevitably the way radical innovation proceeds? Is there any way to accelerate the process to within modern society'seconomic and political time horizon? This is the question that prompted the organization of the Accelerated Radical Innovation(ARI) project. Initiated in 2003, it is a multi-institution effort to develop a systematic process that radically shortens an innovation'slife cycle from initial concept to commercialization, adoption, and societal impact. (The history, theoretical basis, andmethodologyof ARI are described in full in [10–12], In Part 1 of this paper we summarize the ARI methodology as it currently stands, and then inPart 2, we report the results of an empirical verificationwith a radical innovation project that is currently under way.We closewithsome conclusions and lessons learned about the model. Space limitations preclude an extended discussion, which will be thesubject of further publications in the coming year.

2. Part 1. The ARI model

2.1. Some well-known historical examples of accelerated radical innovation

The ARI project began by studying somemajor technological revolutions that have defied the historical pattern of drift and ultimatedisillusionment. Arguably, the archetype of all accelerated radical innovation was the Manhattan Project. In 1932 the last of the majoratomicparticles, theneutron,wasdiscovered.Within ayear, itwas realized that thisparticle couldbeused togenerate a sustainable chainreaction. Six years later,1939, controllednuclearfissionwasdemonstrated. In thesameyear theworldwas facedwithanexistential crisis,the prospect that Nazi Germany could soon have an atomic bomb, prompting Einstein to write his famous call-to action to PresidentRoosevelt. The super-secret Manhattan Project was launched. In another six years, atomic bombs were detonated over two Japanesecities. Despite the vowof Imperial Japan'smilitary command to defend the island to the death and, for the Allies, the prospect of a repeatof theNormandy invasionand its protracted, bloodyaftermath, in threedays the Japanese surrenderedunconditionallyandWorldWar IIwas over. Within thirteen years of the key scientific breakthrough, the world had entered the atomic age.

The Manhattan Project may have been the most dramatic example of accelerated radical innovation, but it is certainly not alone. Ittook twelve years from the launch of Sputnik to men walking on the surface of the moon. It took eight from the invention of themicroprocessor to the beginning of the era of the ubiquitous personal computer. Cellular telecommunications took a bit longer, but sinceit got traction about eighteen years ago, nearly half the planet has a cell phone subscription [13]. The Internet exploded from a restricteddefense-related network to the currentWorldWideWeb in about ten years, with about 100 millionwebsites [14], accelerated by waveafterwave of follow-on innovations such as Amazon.com, eBay, andGoogle. The genomics revolution is now in full swing, and it appearswe’re embarking on the equivalent of another Manhattan Project for batteries and other new energy technologies.

2.2. Lessons from past radical innovation

From our review of these and other radical innovations reported in the literature, we have drawn three major lessons: thatsuccessful radical innovations require a major disruptive event (crisis or opportunity) as their impetus, that all major innovationsproceed along a technology life cycle, and that every innovation, no matter how radical or revolutionary, builds upon priorachievement.

2.2.1. Lesson 1. Radical innovation starts with a crisis or opportunityEach of the successful radical innovations we studied got its impetus from a major crisis or market opportunity, a driving

external force that was powerful enough to propel the innovation forward through the fog of risk and uncertainty surrounding itand past whatever major obstacles and setbacks the innovation inevitably encountered. This force may be a societal crisis, such asthe prospect of Nazi Germany acquiring the atomic bomb, or a major technological discontinuity, such as the development of themicroprocessor, which shortly gave rise to the information revolution.

2.2.2. Lesson 2. All innovation proceeds along a technology life cycleThe second lesson we have learned is that, even with the strongest impetus behind it, radical innovation cannot be rushed.

Every successful major innovation passes through an industrial life cycle from the initial recognition of an opportunity or threat

Please cite this article as: J.A. Bers, et al., Accelerated radical innovation: Theory and application, Technological Forecasting &Social Change (2008), doi:10.1016/j.techfore.2008.08.013


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and through multiple stages of experiment, design, development, and testing before it realizes its economic or social potential.Every stage of the industrial-technology life cycle makes a necessary contribution and must be traversed. The key to acceleratingradical innovation is not to find shortcuts around the life cycle but to understand how it unfolds and to find ways to manage it on abetter planned, better informed basis, which brings us to the third major lesson.

2.2.3. Lesson 3. Every major innovation, no matter how radical, builds on prior achievementWhether it was theWright brothers and human-powered flight, the Manhattan Project, the cellular phone, themicroprocessor,

or the World-wide Web, the innovation was constructed in large measure by applying, extending, or reconfiguring what wasknown or available to new social purposes [15–17]. This will come as no surprise.What is surprising is that the time, effort, and costof accessing the corpus of prior knowledge has been reduced by information technology by orders of magnitude. What once tookyears of painstaking research and correspondence or was available only to companies or government agencies with vast resourcescan now be accessed by innovation teams of almost any size with limited effort and expense through the use of readily availableinformation retrieval, pattern recognition, and knowledge management tools.

2.3. How the accelerated radical innovation model works

From these lessons, as will be explained, we were able to construct a generalized model for ARI. If we accept the industrial-technology life cycle, encompassing the innovation process from inception through implementation and market maturity as theframework, we can map an innovation onto this framework (see Fig. 1), and then seek opportunities for taking time, cost, and riskout of the development-commercialization cycle (the steeper, taller curve in Fig. 1).

Locating an innovationwithin its life cycle framework demands that an important question be answered: bywhatmetric dowegauge the innovation's position and progress along the path of its life cycle? How dowe knowwhere the innovation is today, whenhas it reachedmaturity, and howmuch progress is needed to get there? This metric is referred to as the innovation's figure of merit(the dimension of the vertical axis in Fig.1). For typical radical innovations, there may bemultiple figures of merit. Having preciselydefined figures of merit sets the stage for rest of the innovation process—we understand the magnitude of the task before us, andwe can begin to ask whether it is achievable and how to get there — faster and at lower-cost and manageable risk.

Fig. 1. ARI methodology model emphasizing market acceleration and time compression within the industry life cycle of an innovation. Key analysis points are ARISteps 1, 3, 6, 7, and 8.



4 Two steps shown in Fig. 1 (11: Incremental Innovation, and 12: Next Generation Innovation) are part of an innovation's overall technology life cycle, but theARI methodology, shown in Fig. 2, focuses on the first ten critical steps before a standard design is established.

Fig. 2. Framework of the 10-step 2nd generation ARI methodology.


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If we decompose the industrial life cycle into its known definable stages, and then overlay on these stages the logical activitiesthat propel the innovation from one stage to the next, we end up with a methodology dynamics diagram, shown in Fig. 2.

Fig. 2 is a flow diagram indicating a logical progression of ten steps comprising themethodology. These steps fall into two broadphases, an Inception Phase (Steps 1–6) followed by an Implementation Phase (Steps 7–10).4 The major steps will be described insequence, but in fact the methodology is both concurrent and iterative.

Below, we review the major steps (1, 3, 6, 7, and 8) and the large graphic at the center of the diagram, to discover how thesesteps can contribute to accelerating the innovation through the life cycle.

2.3.1. Step 1. Recognize 10× force crisisAs we observed above, behind every successful radical innovation we studied was a motive force that drove the innovation

forward. Which way are the winds blowing? Are they behind your sails, or are you trying to sail directly into them? Without aclearly identified crisis or opportunity, the radical innovation will drift or founder.

The existence of a clearly recognized crisis or opportunity operates as an initial screen — if one is not apparent, then low-scaleinvestigativeworkmay continue, but the timing is not yet right for this innovation to proceed to commercialization. Clearing Step 1doesn't necessarily accelerate a radical innovation, but it dramatically raises its chances of success.

2.3.2. Step 3. Identify grand challengesThat a radical innovation will face challenges is beyond question. But in conventional innovation processes, perhaps to avoid

becoming overwhelmed at the outset, the innovator typically focuses first on the scientific and technological domain, deferringconsideration of market/societal and business and organizational challenges. That can lead to unpleasant surprises downstream inthe process, requiring costly and time-consuming recycling. To minimize such surprises, and to accelerate the subsequent steps,ARI works by front-loading— identifying and pursuing the key challenges in all four domains simultaneously and synergistically—and from the outset of the innovation cycle [10] (Step 3 of Fig. 2).

2.3.3. The core of ARI: systematic competitive intelligenceBut how can an innovation team, particularly a small one with limited resources and attention capabilities, acquire, interpret,

and act upon all this information? To facilitate this, the ARI methodology builds on the rapidly advancing field of worldwide



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information retrieval, pattern recognition, and knowledge management. Tools that have been developed only in the past ten yearscan systematically scan available knowledge, extract relevant intelligence through pattern recognition and data mining, and feed itinto every phase of the innovation process (center element in Fig. 2). The power, range, precision, and decreasing cost of knowledgecapture tools have put them in reach of even entrepreneurial innovators, allowing them to quickly determine the key issues anddevelopments in their innovation area, and to identify who is working in the same or allied areas. If an area is being investigated—

anywhere in the world — and if the investigator has chosen to make his/her work publicly available, the innovator is likely to beable to learn of it and to initiate a contact. We refer to this activity, at the core of the ARI model, as competitive intelligence, but notin the restricted sense of acquiring intelligence about particular competitors, but in the broad sense of managing all the intelligenceneeded for the innovation itself to be competitive in the marketplace. The application of these tools, one of the major priorities ofthe ARI team, is discussed in references [19] and [20].

2.3.4. Step 6. Establish ARI system visionComprehensive, in-depth front-end analysis will minimize the heavy lifting of actually commercializing the innovation, but for

breakthrough or radical innovation, the expensive, risky, time-consuming processes of commercialization (Steps 7–10 of Fig. 2)cannot be eliminated altogether. There comes a point where significant long-term commitments must be made — by investors,partners, and other stakeholders, and they will not commit until they have a detailed, specific vision of how the innovation willplay out as a commercial proposition [18] (see Step 6 of Fig. 2). The system definition stage of the ARI methodology distills theinnovation concept to a high-level vision that offers the innovation team and its partners an essential turning point betweenanalysis and action in the innovation cycle. It serves as a rallying point for eliciting the commitment the innovation will requirefrom the key stakeholders and constituencies.

At the core of this vision are two key elements. The first is a business model — the method by which value is created for themarket and captured by the every participant in the value innovation network. Particularly for disruptive radical innovations, thebusiness model may require as much innovation or invention as the technology itself [9,21].

The second key element is a commercialization roadmap — a system-level view of the innovation project and a specificblueprint for action by all participants in the value network. Commercialization roadmapping is a tool for translating analysis andstrategies into actionable plans by distilling them into graphical maps showing the interrelationship of objectives, activities,milestones, and the resources required to achieve them (people, departments, budgets, core competencies, etc.). When multiplegroups and organizations must act in concert (as discussed under Step 7 below), a commercialization roadmap is indispensable[22].

2.3.5. Step 7. Form value innovation networkRadical innovation has little respect for organizational boundaries— if you want to bring it about, and particularly, to accelerate

it, you have no alternative but to reach out to all the stakeholders who can play a role (positive or negative) in its commercialization[23]. These stakeholders may include suppliers, downstream players such as systems integrators and distributors, customersthemselves, and those who surround the innovation in other ways — developers of complementary and supporting technology,influential individuals, infrastructure providers, training institutions, and regulators. A key premise of the ARI model is to not waitfor stakeholders to appear before dealingwith them, but to proactively identify them, connect with them, and organize them into avalue network that moves the innovation forward in concert (Step 7 of Fig. 2).

2.3.6. Step 8. Accelerated innovation prototypingRadical innovation is a venture into the unknown, No matter how much analysis or system specification is done in advance,

many barriers and uncertainties — whether technical, operational, commercial, regulatory, or economic — will remain to beresolved before operational scale-up makes sense. The ARI model embraces the concept of probe-and-learn — designing andimplementing a series of inexpensive, low-risk, small-scale experiments (computer modeling, simulation, physical scale models,pilot tests, etc.) to test hypotheses about how to resolve the outstanding barriers to commercialization (refer to Fig. 2 Step 8:Accelerated Innovation Prototyping). (Think of the Special Forces engaging in lightning-fast forays behind enemy lines to probetheir defenses.) If a particular hypothesis turns out to be wrong, little time or money is wasted, but the results point the innovationteam into other, perhaps more productive paths, so that the team can zero in on an optimal solution more rapidly than if it hadchosen a single path that turned out to be a dead end [18,24–27].

3. Part 2. Toward a validation of the ARI model: a retrospective analysis of an ongoing radical innovation project

The second purpose of this paper is to determine what support for the ARI methodology can be found by analyzing an actualongoing radical innovation project. Perhaps the ideal “test” of the ARI methodology would be to apply it to several randomlychosen ongoing radical innovations from their inception forward (prospectively) and determine whether the course of theinnovations indeed had been accelerated relative to that of an appropriate control group. But even within the compressed timeframe of ARI, that would be a multi-year process, proceeding only as fast as the innovations themselves. So that test will have toawait a future study. Instead, we have chosen to apply ARI retrospectively and contemporaneously to the actual course of a radicalinnovation that has been under way for several years. Even in this limited test, we are able to assess howwell the course of a radicalinnovation project tracks with ARI and whether the course of this project offers any guidance in the ongoing development of theARI model.




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The innovation chosen is a major potential advance in cancer therapy by a university spin-out company, MXISystems, Inc.(http://www.mxisystems.com/about.html). MXISystems was chosen as an exemplar of accelerated radical innovation because thistechnology is both radical and disruptive, and potentially amajor advance in one of theworld's most serious health care challenges.(In a discussion with MXISystems' CEO, the innovation scholar Clayton Christensen called its monochromatic X-rays the purestexample of a disruptive innovation he had encountered [28].) The technology, embodied in an external beam radiation therapy(EBRT) machine called Omni, is a pulsed, tunable monochromatic X-ray system. It originated in research at the VanderbiltUniversity Medical Center's Free Electron Laser Center (http://www.vanderbilt.edu/fel/) and was later spun out into a privatecompany, MXISystems Inc., which is now commercializing the system. If it is accepted by the radiology community, Omni promisesdramatically improved therapy outcomes for several types of deep-seated and heretofore treatment-resistant cancer. Thistechnology also can provide unprecedented precision and sensitivity in diagnostic imaging (e.g., breast cancer screening) andoffers promise in a broad range of other fields from protein crystallography for proteomics and drug development to non-destructive testing of industrial products to advanced surveillance. For further information, the MXISystems technology and theapplication of ARI methodology to MXISystems is described in a more detailed paper presented at the PICMET '07 Conference [29].

3.1. Methodology

Informationwas collected by two of the authors (Bers and Dubrovensky) through review of company documents and extensiveinterviews with the CEO, academic and clinical research colleagues in radiation oncology, and associates of the company in theinvestment community (interview participants are identified in the Acknowledgments below).

The information was then correlated with the ARI methodology framework (Fig. 2). Questions considered included:

1. Does the ARI methodology predict or explain the actual course of this innovation?2. Where does the innovation project appear to diverge from the approach the ARI methodology would suggest if the innovator

had been applying it all along?3. Are there outcomes of the project that might have been different or better if the ARI methodology had been followed?4. What processes or outcomes of the project did the ARI methodology miss?5. What can this innovation project teach the ARI project team about areas of the methodology to refine, revise, scrap or add?

3.2. Findings

Meaningful application of the ARI model to any particular innovation requires a plunge into the innovation's domain. In thissection, some technical discussion is necessary, but is kept to a minimum.

3.2.1. Mapping MXISystems onto the life cycle framework

As explained above, before we can proceed through the ARI model, we need to locate MXISystems within its technology lifecycle (Fig. 1). In the course of mapping the innovation within this framework, we will come to grips with the following questions:what are the applicable figures of merit for this innovation, where is it relative to its fully realized commercial potential, and whatis the magnitude of the task ahead?

For medical innovations in general, efficacy and safety are primary figures of merit. If these are established, then secondaryconsiderations of cost and practicality come to the fore.

For cancer therapies, a key measure of efficacy is the level and permanence of tumor regression. Since the danger of a tumorgrows exponentially with its mass, two figures of merit by which all cancer therapies are measured are tumor regression (by whatpercentage the mass of tumor tissue is shrunk) and permanence of the tumor regression (how long the tumor regression lasts). Bothfactors can be accurately assessed through standard imaging techniques.

A key measure of safety for cancer therapies is their toxicity. When exposed to a sufficient dose of radiation, any of a patient'scells (healthy or cancerous) could be destroyed. So a figure of merit is needed to capture the level of effectiveness at a particularradiation dosage. Because cancer patients are generally dosed to tolerance (the dosage their body can tolerate without irreversibletissue damage), a therapy that delivers several times the treatment effect at any dosage level relative to the current (megavoltagepolychromatic) X-ray beam technology, will be that much less toxic than current treatment modalities. This multiplier is referredto as the dose enhancement ratio. The potential for monochromatic X-rays to increase dose enhancement ratio by a factor of sixwould be embraced by the radiation oncology community.

Where is MXISystems' monochromatic X-ray systemwith respect to these figures of merit? At this point, MXISystems is at theproof-of-concept stage of its life cycle. Published images of a human hand skeleton and custom-made breast phantoms composedof breast-equivalent materials show significantly higher discrimination of tissue and “lesions” than those from state-of-the-artpolychromatic X-rays [30]. Currently a version is being developed for small-animal imaging. Although proof-of-principle of thevarious concepts comprising Omni has been achieved, the system has not undergone clinical trials that would definitively establishits efficacy and safety.

Important secondary factors include the size of the system (relative to the space available in a typical clinical setting),duration of the treatment, patient comfort, difficulty of administration (including the safety of the radiation therapist), andcompatibility with the established protocols of the radiation oncology community. Of these secondary factors, the most


http://www.mxisystems.com/about.html

http://www.vanderbilt.edu/fel/


Fig. 3. The original prototype of the MXISystems' monochromatic X-ray system. Components were spread out for ease of adjustment and modification.


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challenging has turned out to be the size of the system. The original prototype of Omni took up a small building (see Fig. 3), andwasnot practical for clinical application.

The current prototype has been shrunk to about half the size of a tractor trailer (see Fig. 4) [30].One major contributor to the size of conventional (polychromatic) X-ray systems, radiation shielding, is eliminated with

monochromatic X-rays (see discussion below). But for Omni to become practicable in typical clinical settings, the system footprintwill have to be reduced further. It is projected that with next-generation (Laser-Wakefield) accelerator technology, the footprint ofthe accelerator could be reduced to that of a medium size crate and perhaps ultimately the size of a pizza box, but Laser-Wakefieldis at least five years away.

Applying the life cycle approach to MXISystems has forced an important question — what for this innovation is the figure ofmerit bywhichwe judge its stage of development? Answering that question, and gauging its position on this figure of merit, allowsus to be very specific about what must be accomplished to achieve a standard design and which objectives should receive priority.In this case, we determine that the objectives of efficacy (tumor regression) and safety (dose enhancement ratio) should beaddressed first, followed quickly by the achieving a clinically practicable footprint.

Understanding MXISystems' position in its technology life cycle, we are ready to analyze its progress along the life cycle,starting with the external impetus that is driving it forward.

3.2.2. Step 1: the 10× force crisis facing MXISystems

Was a crisis or opportunity driving MXISystems' innovation? Everyone is familiar with the scourge of cancer, and researchinstitutions around the world are working on all sorts of promising new therapies and diagnostic procedures. So, in the mind of aninvestor, what setsMXISystems apart from the crowd?As it turns out,MXISystems offers radiation oncologists away to break througha barrier that has long frustrated their ability to treat tumors that are deep-seated, havemetastasized, and are otherwise hard to treat.That barrier is the radiation dosage that the patient is able to tolerate that we referred to above. For themillions of patients they treatevery year oncologistsmust skirt a thin line,making tradeoffs between the upper limits of dosage tolerance and theminimumeffectivedosage required for therapy. Conventional polychromatic radiation therapy and chemotherapy as well, cannot be prevented fromdamagingnormal tissue surrounding the tumor. But themonochromatic X-ray can be tuned to precisely the frequency that is absorbedby the cancerous cells and not by normal tissue [29,31].5 MXISystems' research has shown that the same or better results can beachieved in the treatment/killing of cancerous tumors with five to six times less radiation than conventional radiation therapy, therebyreducing collateral damage to surrounding tissue five-to-six-fold. So harmless is this level of radiation to normal tissue that radiationtherapists do not have to take any measures to prevent exposure, and no radiation shielding is required at the therapy site. Anadvantage of this sort means that MXISystems passes the crisis/opportunity test with flying colors.

3.2.3. Step 3: identifying the grand challenges before MXISystems

Under the ARImodel, the internal and external environment of the innovation concept is probed deeply to expose any challengesor other issues that should be confronted before moving to the later, far more expensive stages of the development cycle. But in anindustry as complex and constrained asmedical equipment, identifying and assessing challenges on all fronts, not just scientific andtechnological, is a daunting prospect. The temptation is to get the technology right and thenwork through the other issues as theyarise. The founder and CEO of MXISystems is a board-certified diagnostic radiologist with a distinguished academic and clinicalbackground who has surrounded himself with a team of physicists and engineers. If anyone would know the potential traps inlaunching a radically new technology in the diagnostic radiation or radiation oncology specialties, it would be this CEO.

5 Actually, it is not the cancerous tissue itself that the radiation reacts with, but a pre-administered chemical binding agent, such as cis-platinum, that isselectively absorbed by the rapidly-dividing DNA of fast-growing tissue such as active cancer cells. When irradiated at a precise activation energy level, thebinding agent absorbs the energy and releases it in a form that incapacitates the DNA to which it is bound, but does no further damage.



Fig. 4. Schematic of the current version of the monochromatic X-ray system. It is about eighteen feet in length, about half the size of a tractor trailer.


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As aware of the challenges as it was, MXISystems suffered a significant reversal earlier in its history at the hands of marketand regulatory forces, forcing a major course correction. MXISystems' initial foray was not into radiation therapy, but a differentspecialty, diagnostic imaging, specifically mammography.

Traditional (two-dimensional)mammography is notoriously unreliable. The high number of false positives leads to unnecessarybiopsies, while the high proportion of false negatives means that early-stage tumors go undetected just when therapy has thegreatest chance of success [32]. Conventional mammography is also an uncomfortable procedure involving compression of thebreast, deterring many women whose cancers might be identified early. The company saw that monochromatic X-rays could beused to painlessly image the breast, and provide physicians with far clearer three-dimensional images. But well into thedevelopment of the imaging system, MXISystems got tripped up by a pair of factors.

The first was the Mammogram Quality Standard Act (MQSA), enacted in response to a groundswell of dissatisfaction with theoverall quality of mammography under previous voluntary standards [32,33]. The rigorous screening and inspection requirementsimposed on mammography facilities by this act made it virtually impossible for MXISystems to get FDA fast-track approval for itsmammography application. Before it could be adopted by clinics, the systemwould have to undergo a full (approximately 5-year)FDA clinical trial and approval by the Bureau of Radiological Health.

The second factor tripping up MXISystems was the economics of U.S. health care. This issue exposed a flaw in MXISystems'business model, as will be explained in the discussion of ARI Step 6. Together, these two unanticipated issues forced a majormidcourse correction in MXISystems' path that cost it several precious years.

3.2.4. Applying systematic competitive intelligence to MXISystems

In today's dynamic innovation playing field, advances are occurring at a breakneck pace worldwide that may createopportunities for leapfrogging around barriers — or competitive threats that may leapfrog around the innovation concept itself.Under the ARI methodology, advanced intelligence tools are applied to probe deeply into the innovation's environment to discoverthese opportunities and threats in real-time or near-real-time.

These tools are particularly necessary in the biomedical domain, andmonochromatic X-rays proved no exception. Several yearsinto its development, a competing approach emerged that is based on the major alternative to external beam radiation fordelivering radiation to a tumor. So-called brachytherapy involves the direct insertion via catheter of a “hot” radioactive source(radionuclide), usually no larger than a rice grain, into a local tumor site. After the cancerous tissue is exposed to this lethal dose ofradioactivity for a predetermined length of time, the source is either removed from the patient or decays naturally [34].Brachytherapy is best suited to localized cancers that can be reached with a catheter. For deep-seated, inaccessible tumors or forcancer that has metastasized to many parts of the body, external beam radiation becomes more practicable. Brachytherapy shareswith external beam radiation therapy the problem of high toxicity and dosage tolerance limitations. But the idea of using aprecisely tuned source ofmonochromatic X-rays to overcome toxicity limitationswas also under development for brachytherapy. Asearch turned up a radioactive element, ytterbium, that emits radiation at exactly the frequency that is absorbed by cis-platinum,the DNA binding agent used with monochromatic X-rays. For the sorts of tumors for which brachytherapy is suited, use ofytterbium as the radionuclide gives brachytherapy the same low-toxicity benefit as monochromatic X-rays, but with the additionaladvantage of using in-place brachytherapy administration equipment rather than a yet-to-be manufactured monochromatic X-raymachine. As soon as Ytterbium became commercially available, in early 2007, a clinical trial of this procedure was started [35].

While finding the brachytherapy alternative on the radar screen came as a surprise, it is by no means a fatal blow toMXISystems. Monochromatic X-rays delivered by external beam still have several advantages. For smaller, widely dispersed, deep-seated tumors, brachytherapy in any form is impractical; external beam radiation offers a cleaner, broader sweep of the affectedareas. Brachytherapy involves catheterization, a cumbersome, uncomfortable, difficult, and invasive procedure. Becauseradioactive ytterbium has a short half-life (from 20 min to 36 days depending on the isotope), it must be reinjected severaltimes over the course of treatment, while the binding agent used in external beam radiation, once injected, can be irradiatedrepeatedly with no loss of effectiveness. And should radiologists need to replace cis-platinum with another binding agent, anotherradionuclide thanytterbiumwould need to be found, while themonochromatic X-ray is tunable to the frequency of any binding agent.




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Despite these advantages, this sort of competitive intelligence can help MXISystems avoid an expensive frontal attack on the widelyused, well-entrenched brachytherapy approach and focus on those tumors where it is the only practical alternative.

3.2.5. Step 6. Establishing a total system vision for MXISystems

As explained earlier, before investors and other key stakeholders make the deep commitments required to bring an innovationconcept to market, they seek evidence of its commercial viability. One key element of this “story” is the business model, themechanism by which value is created for the market and profits are captured by all the participants in the value network. This ideasounds so obvious in principle (Why go forward if these conditions aren't the case?) that one might wonder why it needs suchcareful attention as part of the envisioning process. And yet, like many other radical innovators, MXISystems learned well into itsdevelopment cycle, that the business model on which its original application was premised was unworkable, forcing a painfulcourse correction that cost it several years.

As explained, MXISystems' X-ray systemwas originally intended as a superior approach to mammography (its founder and CEOis a diagnostic radiologist). The business model for the systemwas predicated on a level of third party reimbursement that wouldreflect its greater diagnostic effectiveness and the reduced downstream costs for additional diagnostic procedures and therapy.

That reasonable assumption proved incorrect. Cancer centers and other health care providers are not reimbursed for healthoutcomes, but for the procedure, usually according to a fixed reimbursement schedule. Sometimes payers recognize that a newdiagnostic or therapeutic approach yields more benefit and adjust the reimbursement rate, but the norm has been to maintain theexisting reimbursement rate and let the provider determine themost cost-effective therapeutic approach. ForMXISystems thatmeanscapital and recurring procedure costs should be comparable to those for conventional polychromaticmammograms, even thoughMXIproduces a 1000-slice three-dimensional CT image (vs. a single two-dimensional image) at one-fifth the radiation exposure to thepatient. (For a comparison of monochromatic and polychromatic images, please refer to http://www.mxisystems.com/images.html.)

Several years into the development cycle MXISystems learned that the economics weren't in place to support widespreadadoption of its mammography system. MXISystems' business case showed that the procedure would be profitable for amammography center if it could charge $200 per procedure. But mammography is preventive medicine, which payers treat muchmore parsimoniously than acute care. Two hundred dollars is twice the fixed reimbursement rate set by the Center for Medicareand Medicaid Services (CMS) and private payers for mammography screening. Yet even the $100 rate is above providers’ cost, andas a result, awhole industry of stand-alonemammography services has virtually disappeared. Mammography is now available onlyat hospital-affiliated clinics and general-purpose diagnostic centers, and is regarded as charitable care [36].

For many innovations such a surprisewould prove fatal to its prospects. Fortunately, monochromatic X-rays can be harnessed toawide range of applications, both medical and non-medical. The nearest logical medical applicationwas in the other major branchof radiology, radiation therapy, where the samemonochromatic X-rays that are used to light up cancer tissue can be used, at higherdosages, to selectively target and destroy it. But years of effort and investment were lost before the economic fallacy behind theoriginal business model was discovered.

3.2.6. Step 7. Mobilizing MXISystems' stakeholders into a value innovation network

The U.S. health care system is so vast and complex, with so many players, that for one small, underfinanced player such asMXISystems to make any headway at all, it must mobilize a huge constituency of stakeholders. MXISystems is a good test of thevalue and importance of stakeholder mobilization.

For MXISystems, these stakeholders include clinical trial sites (human and large-mammal testing), an accelerator manufac-turing partner, a development partner for the next-generation accelerator, a partner to develop treatment protocol software and acontrol module, and of course, financial partners.

With its severely constrained resources, MXISystems had to orchestrate these key partners and stakeholders carefully. So far, ithas found the going slow. It is still trying to line up support from a few major academic or cancer research centers, which in turninfluence the stance of the larger, more conservative radiation oncology community. FDA approval is a huge hurdle, a key stickingpoint for both the medical and financial communities.

To secure private equity financing and explore other commercialization options such as acquisition by a manufacturer, MXIhired an investment banking firm in late 2002. This firm contacted 148 venture capital and private equity firms and sixteenstrategic investors (major companies in themedical radiation industry whomight viewMXI technology as fitting into or extendingtheir own technology portfolios).

Getting a deal with established companies depends strongly on chance and timing – presenting themwith an innovation thathappens to fill a strategic gap at just the right time. For the strategic investors MXISystems approached, the concept was eithersomewhat off their strategic direction (as would be expected of a novel technical concept); it was too threatening to their corebusiness (e.g., brachytherapy, polychromatic external beam radiation therapy systems, diagnostic imaging systems); they didn'twant to take on GE, the diagnostic imaging leader; or it was too early and too risky to take on.

Most of the discussions were with venture capitalists and other potential financial investors. Although they came close to a dealseveral times, all the discussions eventually collapsed. For the venture capital firms, the $5–10 M of very early-stage capital thatMXISystems' needed wasmore than they were really positioned to take on. In the biomedical domain venture capitalists seem betterpositioned tomake smaller, less risky investmentswith quicker returns, in stents and biotechnology, for example, vs. technically risky,big-ticket capital equipment. They saw monochromatic X-rays as too early-stage, unproven, with the clinical trials still before them.


http://www.mxisystems.com/images.html



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The venture capital community prefers to step back andwait for competing approaches to sort themselves out in themarket (or in thiscase, gain FDAapproval) beforemaking theirmove. Theywere also troubledbywhat they sawas a lack of entrepreneurialmanagementdepthatMXISystems— a team that could takemonochromatic X-rays all thewayandproduce anear-term, reasonably certain liquidityevent. Last, MXISystems' timingwas unfortunate— just after the 2001 technology stock crash, when capital for seed stage technologydried up and venture capital firms were pulling in their horns, focusing on lower-risk, later-stage technology [37].

In retrospect, it is apparent that MXISystems approached the investment community too early; more recent effort has focused onphilanthropists, Government, foundations, and other seed stage sources with less of a concern for near-term return-on-investment.

The search for a manufacturing partner to produce the accelerator also proved frustrating. While there is a large, profitable,manufacturing base for accelerator technology, developing an accelerator to produce monochromatic X-rays would be a majorstrategic investment. MXISystems found itself in a similar Catch-22 with manufacturers as with the venture capital community.Before they will make the investment, manufacturers must be persuaded (by clinical evidence and the opinions of the radiologycommunity) of a large market for monochromatic X-ray systems. But without an available system on which to test Omni's clinicalefficacy, clinicians cannot provide the evidence the manufacturers need. The prospect of multiple profit streams, including fromnon-medical applications, would make accelerator technology more attractive to manufacturers, but at the time, MXISystems wastoo stretched to pursue those applications.

It is with good reason that scholars call this period between proof-of-concept and commercial realization the Valley of Death orthe Darwinian Sea [18]. These Catch-22 loops — trying to get all the pieces in place that key partners would like to see before theysign on— are an all but inevitable dilemma for radical innovators. The ARI methodology offers a way through this dreaded period,as discussed under ARI Step 8, Accelerated Innovation Prototyping.

3.2.7. Step 8. Accelerated innovation prototyping to resolve MXISystems' commercialization issues

MXISystems is just now on the cusp of Step 8. But some early moves in this direction shed light on the difficulties an innovationteam can encounter in this crucial step.

If resources were sufficient and time were not at issue, most barriers to commercialization eventually could be breached.But there is never enough of either commodity, so getting to the other side of the Valley of Death is a matter of conservingresources and surviving long enough to work through the barriers. For most radical innovators that means working on ashoestring. On this front MXISystems made all the right moves. The principals worked out of their homes, took out the secondmortgages, hired no staff, worked through partners, and kept both business and personal expenses down to an absoluteminimum — for years.

Where does ARI come in here? The ARI methodology can't eliminate the barriers or create time or resources but it can offer theinnovation team away tomake smarter use of both. Bymeans of Step 8, the Accelerated Innovation Prototyping process (Fig. 2), theinnovator “stages” the key development activities so that limited resources are focused on addressing the most critical challengesbefore turning to other challenges.

This staging process has proved a critical, nearly insurmountable, challenge in the history of MXISystems. Given the company'sseverely limited resources, the CEO was stretched on too many fronts at one time, working simultaneously on clinical,manufacturing, technical, financial, and organizational issues. As we saw, MXISystems pursued investment capital before thiscommunity was ready or able to commit the substantial capital required, with the result that the key funding required to push thetechnology forward was not forthcoming when it was most desperately needed. This was just one piece of a huge Catch-22problem: before considering adoption, the radiation oncology community needed the assurance of FDA approval. But FDA approvalrequires an expensive, risky multi-year clinical trial. The radiology community also needed assurance that the system is affordableand practical in a standard clinical environment, but those who could address this issue, equipment manufacturers, were deterredfrom taking the risk of building an industrial infrastructure for the key device, an affordable and clinically practical accelerator.Investors were not forthcoming because, among other concerns, they viewed monochromatic X-rays as an expensive, long-term,high-risk project with no assurance of commitment from the clinical community. Everywhere they turned, it seems, theMXISystems staff was turned down for seemingly legitimate reasons.

How might accelerated innovation prototyping have helped here? The ARI process confirmed that the barrier that stoppedprogress with clinicians, manufacturers, and investors was the clinical trial. So the clinical trial must be the first priority. But howcould MXISystems find its way through this barrier?

MXISystems already has completed proof-of-concept level experiments using computer simulation and phantom testing withcadavers, small animals, and simulated human tissue [30]. The next logical step down this path is the use of live animal trials (smallmammals followed by large mammals) to provide initial evidence of the efficacy of the Omni system. Animal trials could be donebefore clinical trials were started, but only with synchrotrons, enormous circular particle accelerators (averaging over 100 m indiameter) for conducting research in high-energy physics that are far beyond the resources and capabilities of medical research orclinical facilities. (There are twenty synchrotrons in operation around the world, generally funded by national science agencies orintergovernmental consortia [38].) Because the costs of animal trials are low compared to the costs of conducting human trials,early-stage funding sources such as Government agencies, foundations, and philanthropists might find the technology anattractive research project. Animal trials could provide crucial evidence and credibility to build a case for human trials, with theFDA and the clinical community, and perhaps some additional sources within the financial community. Perhaps a prospectivemanufacturing partner, seeing that a good deal of the clinical risk was removed by successful animal trials, could be persuaded toprovide financial support for human clinical trials. Other issues, such as large-scale funding, building a manufacturing base, driving




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down the cost of the accelerator, and reducing its footprint, important as they were, could be deferred until the animal, and laterhuman, trials proved successful.

It is difficult to intentionally set aside issues that eventually must be resolved, but that is exactly the staged thinking disciplinethat the ARI methodology demands, and it might have smoothed the path for MXISystems.

3.3. Case study conclusions

We have attempted only a partial validation of the ARI methodology — with one case, analyzed retrospectively. While we candraw only limited conclusions about the general applicability of the ARI model as a guide to other innovations, we advance thefollowing tentative conclusions about what this case tells us about how ARI might perform more generally.

By and large, MXISystems' strategies and actions were consistent with the ARI methodology, particularly Step 1 (Recognize 10×Force Crisis), Step 3 (Identify Grand Challenges), 6 (Establish ARI System Vision), and 7 (Form Value Innovation Network). Thisconsistency confirms that the ARI methodology tracks closely with at least one instance of how radical innovation unfolds.

But the ARI model went beyond merely tracking reality. The application of the ARI model appears to have “made sense”(at least retrospectively) of a complex innovation process that proceeded in the free-for-all milieu that is at the cutting edgeof a technologically advanced market economy. The rationalization of the innovation process that ARI offers could helpinnovation teams to develop a conscious strategy and a structure for negotiating their innovation through such a chaoticenvironment.

Third, the ARI model exposed critical issues that needed to be addressed along theway, and potentially earlier in the innovationcycle, where they could have been disposed of relatively quickly and inexpensively, and accelerating later steps in the cycle.

For example, could the application of Step 3 (Identify Grand Challenges) and Step 6 (Establish ARI System Vision) haveprevented or forestalled MXISystems' initial foray into mammography? In these steps, tough questions are raised at the front endsuch as, “How will it be paid for, by whom; what is the business model; and what regulatory or public policy constraints mightimpede the adoption of this innovation?” It is impossible to determine in retrospect, but adherence to themethodologymight havehelped MXISystems move directly into the higher-priority, higher margin therapy application.

Fourth, the application of Systematic Competitive Intelligence might have alerted MXISystems to a parallel monochromaticradiation delivery approach developing in the brachytherapy branch of radiation therapy. This development could be interpretedas competition for monochromatic X-rays, or perhaps as a precursor form of single-frequency radiation as a clinically superiormethod for destroying tumors.

Last, through Step 8 (Accelerated Innovation Prototyping), the ARI model can help the innovator “stage” the key developmentactivities so that resources are focused on addressing critical challenges before turning to secondary challenges. If the sequence ofexperiments has been carefully staged, surmounting the primary challenges can give the innovation team a major leg up onsubsequent challenges. For MXISystems successful large-mammal tests might strengthen the team's case with the FDA andprospective manufacturing and financial partners.

Overall, the verification study confirms the potential of the ARI model to put the radical innovation process on a faster, lower-cost, better-managed track.

4. Overall conclusions

There is no shortage of radical innovation concepts that could make a significant positive impact on the global economy. Most ofthese concepts fail to reach the market. Of the failures, many probably deserve to fail for all sorts of legitimate technical, economic, ormarket reasons. But many others fail because they exceed the risk tolerance and the time horizon of even enlightened executives andinvestors. ARI is an innovationmethodology that seeks to drive enough time, cost, and risk out of the process of radical innovation thatthese innovation concepts will fit comfortably within the financial horizon of the business and investment community.

The ARI methodology accelerates the innovation cycle through the application of five ideas.

• First, it places any innovation concept in on its technology life cycle trajectory, allowing the innovation team to pinpoint where itstands, where it would be when fully mature, and what steps are needed to drive it forward.

• Second, the ARI methodology offers a systematic approach to conceptualizing the innovation — explicitly linking it to an actualcrisis or opportunity (a sufficiently powerful “driver”), envisioning the innovation as a total system (reducing the chances that animportant system element will be overlooked), and thinking through the linkages to the external systems (e.g., supportingtechnologies, supply chains, customer processes, etc.).

• Third, to enable the innovation team to recognize and confront the full range of issues that they are likely to encounter as theywork toward the realization of this total system vision, the ARI model employs the tools of competitive technology intelligence—upfront and concurrently.

• Fourth, the methodology takes into explicit account the dependence of the innovation vision on a broad range of stakeholders. Ithelps the innovation team to identify all those parties that can advance or inhibit the envisioned innovation system and to forge avalue innovation network that acts out of mutual self-interest to drive the innovation forward.

• Fifth, when those inevitable expensive, hard-to-reverse major commitments are upon the innovation team, ARI offers a stagedthinking discipline (Accelerated Innovation Prototyping) inwhich hurdles are resolved through a process of iterative experimen-tation and experience-based learning that is guided by the end-state vision of the radical innovation [24,26].




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4.1. Future direction for ARI — the innovation scorecard

The accelerated innovation process, as described above — working through a ten-step process, identifying and addressingmultiple challenges upfront and concurrently, managing vast amounts of intelligence, mobilizing a value network of multiplestakeholders, and conducting multiple small-scale experiments and developmental activities — is a complex undertaking. To useanother transportation metaphor, the train could easily go off the rails if everyone involved isn't in synch.

To address this problem, the ARI team is now developing a comprehensive scorecard — a measurement system to track theinnovation's progress through its life cycle from inception through commercialization. The scorecard will include all of the majorattributes the innovation must possess to achieve commercial realization, such as innovation design, manufacturability, reliability,etc. To help the innovation team pinpoint their progress in advancing the innovation along the attribute, a scale will be developedthat will contain a series of progress states through which the innovation must pass. Together the benchmarks will act as a trap,preventing any issue meriting attention from escaping consideration. Using this comprehensive scorecard will help the innovationteam set its agenda for action. It will be able to zero in quickly on the key issues it must address, so it can set its priorities, projectresource requirements, identify partners, communicate with stakeholders, and organize effort.

5. An update on MXISystems

In the interval since this research was completed, MXISystems has made significant progress in breaking the logjam. Animaltrials have been conducted with “outstanding results” at a synchrotron in France, and this group has now started human trials, but,as discussed, a synchrotron is not a reasonable way to do radiation therapy. A “luminary” clinical site to conduct human trials witha commercially viable device is still a necessity. So far, the MD Anderson Cancer Center in Orlando has agreed to conduct clinicaltrials, but MXISystems still must raise $3M to build a machine for their use. The University of Florida Veterinary school has agreedto treat animal tumors, with the same capital constraints. They will share the unit with Shands Hospital to treat brain tumors inhumans as well. Interest in non-medical uses (non-destructive testing and crystallography) is growing, but at $3.5–5.5 M per unit,the buyers must raise the funds to buy them. The accelerators are now readily available, and Omni can now be built from off-the-shelf components. But the Catch-22 continues: clinical facilities will not order a unit until clinical trials are completed, andsomebodywill have to step upwith at least $3M to build one for the clinical trial. MXISystems is in themidst of a $15million roundof financing, with $3M raised as of this writing, but these are difficult times (mid-2008) to be in the capital markets— two sure-firedeals recently fell through when the investors were hit with the subprime mortgage and auction rate securities debacles [36].Before the benefits of monochromatic X-rays will be enjoyed by cancer sufferers and other adopters, it appears that MXISystemswill be swimming in the Darwinian Sea for a bit longer.

Acknowledgments

The authors gratefully acknowledge Dr. Frank E. Carroll, founder and Chief Executive Officer of MXISystems, Inc. for hiscountless hours patiently educating us on his company and on the science and technology behindmonochromatic X-rays. It was Dr.Carroll's courageous willingness to allow us to hold a light toMXISystems, warts and all, that has allowed us to gain insight into theapplication of the ARI model to the unfolding of a major radical innovation.

We also acknowledge the many insights of the following individuals who have been involved in the launch of MXISystems andparticipated in the interviews regarding the scientific, clinical, and business aspects of its development.

• Mr. Christopher Calton, Vice President— Investment Banking; and Mr. Philip Krebs, Senior Managing Partner, Avondale Partners(interviewed Jan. 2, 2007)

• Dr. Dennis M. Duggan, Associate Professor of Medical Physics, Vanderbilt University Medical Center (interviewed Dec. 22, 2006)• Dr. Dennis E. Hallahan, Ingram Professor and Chairman, Vanderbilt Center for Radiation Oncology (interviewed Jan. 3, 2007)• Dr. Kenneth Hogstrom, Professor of Physics and Director, Medical Physics and Health Physics Program, Louisiana State University(interviewed Feb. 14, 2007)

• Dr. Patrick Kupelian, Director of Clinical Research, Department of Radiation Oncology, M. D. Anderson Cancer Center Orlando(interviewed Jan. 26, 2007)

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[1] R. Leifer, Radical innovation: how mature companies can outsmart upstarts, Harvard Business School Press, Boston, 2000 x, 261 pp.[2] C. Lucier, S. Wheeler, R. Habbel, The era of the inclusive leader, Strateg. Bus. 47 (2007).[3] K. Allen, CEO Study: A Statistical Snapshot of Leading CEOs. 2005, 2004 Spencer Stuart.[4] P. Anderson, M.L. Tushman, Technological discontinuities and dominant designs: a cyclical model of technological change, Admin. Sci. Q. 35 (4) (1990) 604.[5] M. Hirooka, Nonlinear dynamism of innovation and business cycles, J. Evol. Econ. 13 (5) (2003) 549.[6] N.D. Kondratiev, The long wave cycle, Richardson & Snyder, [New York], 1984 138 p.[7] Perez, C., Technological revolutions andfinancial capital: the dynamics of bubbles and golden ages. 2002, Cheltenham,UK;Northampton,MA, USA: E. Elgar Pub.[8] J.A. Schumpeter, Capitalism, socialism, and democracy, Harper & Brothers, New York, London, 1942 x, 381 p.[9] C.M. Christensen, M.E. Raynor, The innovator's solution: creating and sustaining successful growth, Harvard Business School Press, Boston, Mass, 2003 x, 304 pp.[10] J.A. Bers, J.P. Dismukes, Principles and practice of accelerated radical innovation, Proceedings of the 2007 Portland International Conference on the

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and the Environment May 8, 1998 Volume, DOI: http://www.hhs.gov/asl/testify/t980508a.html.[33] Frequently Asked Questions About MQSA. 2005 [cited Jan. 23, 2008]; Available from: http://www.fda.gov/CDRH/MAMMOGRAPHY/cons-faq2.html#act.[34] The American Heritage medical dictionary, New updated ed. Houghton Mifflin Co., Boston, 2007 xxxii, 909 p.[35] Hallahan, D., Personal Communication. 2007.[36] Carroll, F., Personal Communication. 2008: Nashville.[37] Krebs, P.D., Senior Managing Partner, Avondale Partners, Personal Communication with J. Bers. 2007.[38] Wikipedia. Synchrotron 2008 July 8, 2008 [cited 2008 July 8, 2008]; Available from: http://en.wikipedia.org/w/index.php?title=Synchrotron&oldid=224344282.

Dr. John A. Bers is Associate Professor of the Practice of Engineering Management at Vanderbilt University's School of Engineering. His interests focus on howtechnology and industrial companies identify actual and hidden assets and realize their business value in current and emerging markets. He has B.S. in PhysicalChemistry (1968) from Yale University, Ed.D in Educational Administration (1975) fromHarvard University, an M.B.A. (1984) from University of Chicago and a Ph.D.in Management of Technology (1998) from Vanderbilt University. His research interests are Technology strategy and marketing.

Dr. John P. Dismukes is a Professor of Chemical and Environmental Engineering Department and the Director of International Accelerated Radical Innovation (ARI)Institute at the College of Engineering in The University of Toledo where he has served as Associate Dean for Research in the College of Engineering from June 1996to June 1999, and as Interim Vice Provost for Research for 7 months during 2000. He has a B.S. in Chemistry (1955) from Auburn University and a Ph.D. in InorganicChemistry (1959) from University of Illinois. His research and teaching interests are in materials science, alternative energy technologies, and methodologies foracceleration of radical innovation.

Dr. Lawrence Miller received a B.A. in Computer Science from the University of Texas at Austin, in December 1986, where he double majored in Computer ScienceandMathematics. He received anM.S. in Computer Science with aminor in Mathematics from Southwest Texas State University in August 1991. He received his Ph.D. from the University of Houston in May 2001. Dr. Miller is currently an Assistant Professor with the Electrical Engineering and Computer Science Department atthe University of Toledo.

Aleksey Dubrovensky is an application engineer with the Cook Compression unit of the Dover Corporation.


http://www.hhs.gov/asl/testify/t980508a.html

http://www.fda.gov/CDRH/MAMMOGRAPHY/cons-faq2.html#act

http://en.wikipedia.org/w/index.php?title=Synchrotron&oldid=224344282


ari - theory and application

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