As computers outperform humans at complex cognitive tasks, disruptive innovation will increasingly remap the familiar with waves of creative destruction. And in healthcare, nowhere is this more apparent or imminent than at the crossroads of Radiology and the emerging field of Clinical Data Science. As leaders in our field, we must shepherd the innovations of cognitive computing by defining its role within diagnostic imaging, while first and foremost ensuring the continued safety of our patients. If we are dismissive, defensive or self-motivated - industry, payers and provider entities will innovate around us achieving different forms of disruption, optimized to serve their own needs. To maintain our leadership position, as we enter the era of machine learning, it is essential that we serve our patients by directly managing the use of clinical data science towards the improvement of care—a position which will only strengthen our relevance in the care process as well as in future federal, commercial and accountable care discussions. We'll explore the state of clinical data science in medical imaging and its potential to improve the quality and relevance of radiology as well as the lives of our patients.