Decision making in medical technology innovation: The case of ultrasound

General characteristics of innovation in medical technology, which are revealed in ultrasound, are indicated. Institutional changes in decision making about medical technology are discussed. The basic change is from prior reliance upon the nongovernmental sector to increasing involvement of the federal government. This change is revealed in the regulation of medical devices and the creation of the National Center for Health Care Technology. Reasons for increasing federal involvement are indicated, the concerns of cost, risk, and efficacy are identified, and the implications for decision making are summarized.