Clayton Christensen, as many of our readers know, pioneered a theory of disruption in business models and a three-step cycle of innovation (empowering, sustaining and efficiency, now quite broken indeed). With two other writers, he applied these theories to healthcare in the 2009 book ‘The Innovator’s Prescription’ which this Editor heard co-author Jason Hwang, MD present in 2009 at the Connected Health Symposium and at a private meeting in 2011. One would think that we’d be well into disruption, which is part of the empowering innovation cycle and which the authors championed in the book as underway.
The surprise at the end of this Mobihealthnews article on his recent presentation at “Better Health” in Boston, a McKesson-sponsored meeting series, was not what constitutes disruption, but that it has not really started yet, four years later. This will be much to the surprise of many successful and unsuccessful companies (Misfit Shine, ZocDoc, Zeo, 23andMe) and health plans which have stoutly touted their products and services as The True Disruptors. Sorry, you may be only a part of the Big Shift: decentralization. Decentralization will push out parts of healthcare off the hospital and doctor’s office to clinics, retail sites, the workplace and the home. The three parts of the hospital function–diagnostics, acute care/surgery and chronic condition management–which presently have three warring business models can then sort themselves out. Telehealth and care management–even senior housing and home care–all have roles particularly in this last area. And whither the patients? Are they drivers or passive consumers? [Ed. note: Innosight, Mr. Christensen’s commercial arm, is working with McKesson.]
This Editor’s partial defense of why disruption is The Dog That Failed To Bark in healthcare is that we in the US are living through an externally imposed Pearl Harbor-style disruption: the Affordable Care Act (ACA), only part of which is insurance with expensive, ineffective health coverage generally classified under Healthcare.gov, but so much more. The real disruption underway in 2009-10 was shunted off to a detour and the car’s gone off a cliff. In the UK, the causes may be different, but the end result is the same–business and care models at war with each other, costing too much; patients shortchanged.
Related article from the Clayton Christensen Institute on the primary care business model.