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HL20: Clayton Christensen—The Innovator's Frustration

Edward Prewitt, for HealthLeaders Media, December 13, 2011

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is the story of Clayton Christensen.

This profile was published in the December, 2011 issue of HealthLeaders magazine.

 "Over time, we'll need fewer and fewer hospitals. Boards of those institutions need to just remember that the scope of what they need to do is to be responsible for the health of people, not the preservation of the institutions."—Clayton Christiansen

Clay Christensen's writings about disruptive innovation—the concept that new technologies often have the potential to turn industries upside down, yet are exceedingly hard for established companies to recognize and harness—gave the Harvard Business School professor status as a management guru in the late 1990s. Manufacturing and technology executives, in particular, read Christensen's books and sought his advice. Hospitals weren't part of the discussion, for the most part.

But Christensen always saw the U.S. healthcare system as ripe for disruptive innovation. In 2009, he coauthored a book, The Innovator's Prescription, and entered the public debate on how to fix healthcare. Disruptive technology has altered the practice of medicine many times over, yet the structure of healthcare institutions and the healthcare system has resisted change, to its detriment, Christensen says.

Medical technology has complexified healthcare enormously, Christensen observes, but medical education "is structured around a model that was created nearly a century ago that focused around the individual caregiver as the source of solutions. Now, because of the advance of technology, caregiving is a process in which dozens and dozens of people contribute, yet we teach as if medicine is still focused around the doctor," he says.

Disruptive technology in many industries tends to undermine experts in favor of laypeople, according to Christensen's research. What was the province of experts such as doctors—blood testing and interpretation, for instance—can now be done by nurses or even patients at home with inexpensive medical equipment or just a smartphone. In this new structure of healthcare, hospitals are often an impediment to change.

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1 comments on "HL20: Clayton Christensen—The Innovator's Frustration"


John J Flavin (12/14/2011 at 8:36 PM)
Mr. Christensen is correct in his posit that the HC institutions and HC system have resisted change. The fundamental driver(s) of this resistance is either a deep rooted belief that HC providers were not to operate from a profit & loss model (e.g. manufacturing company with products) due to the human aspect of their client base or to maintain an intellectual/academic distance separating them from lowly profit and loss considerations. However, the consequences of a failure to intimately understand the sources of profit and cost within a healthcare provider institution nor system has resulted in the runaway costs which the entire industry and nation now try to contain. The lack of financial discipline and competitive forces found in the free market have enabled costs to rise sky high. Analytics are now providing insights to financial leadership within some institutions which serve to substantiate gut feelings or in a worse case illuminate financial realities to the surprise of doctors and administrators. When the "real financial picture" comes to light, the integration of centers of excellence (and the shuttering of those which cannot operate profitably) driven by the correct focus of providing the best care for a given condition will become the needed if not natural order of healthcare provision.