In my recent conversation with Clay Christensen, the Harvard Business School professor and author of The Innovator's Prescription, we talked about his premise that disruptive innovation can cure what ails U.S. healthcare.
Disruptive innovation is the concept that new technologies can turn industries upside down, yet are exceedingly hard for established companies to recognize and harness. While technology might provide the fix for healthcare, it clearly has created a large part of the problem—much of the ever-increasing cost of healthcare is attributable to ever more expensive machines and IT systems. It's worth asking whether the cause of healthcare's problems can really be its solution.
To tease out this conundrum, it helps to think clearly about the different types of technology that affect healthcare. Christensen holds that technology has already disrupted healthcare over the past couple of decades. Yet he's not speaking of electronic medical records or higher-resolution imaging machines.
Rather, technologies such as air travel that affect society on a large scale have undermined the rationale for many hospitals; whereas travel used to be difficult and expensive, nowadays people routinely fly across time zones and even international boundaries for medical procedures. Fewer hospitals are needed as a result.
"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," says Christensen, one of this year's HealthLeaders 20 honorees.
A second type of technology that has changed healthcare fundamentally is the plethora of monitors, testing equipment, and other devices that make the delivery of healthcare possible in any setting—in a retail clinic, at home, or in a hotel room, for instance. Individually, many of these devices are prosaic, but their total impact is enormous.
At HealthLeaders Media's CFO Exchange event in September, Joe Smith, MD, chief medical officer of the West Wireless Health Institute, gave a persuasive keynote address on the potential for wireless devices, along with data analytics, to disrupt (there's that word again) the practice of healthcare.
Now consider that these two categories of technology are not what people talk about when they talk about healthcare IT. Instead, the focus is on EMR, EHR/PHR, CPOE, HIEs, and other of the three-letter acronyms that IT vendors and government agencies love. These informatics solutions have the potential to make healthcare much more efficient, but at a cost.
Yet there is a fourth type of technology that makes healthcare informatics inevitable. The ICU equipment that keeps people alive and allows quick and accurate diagnoses, the operating room devices that make formerly improbable procedures now routine, the medical devices that return sick people to a relatively normal life—this kind of medical technology is a wonder of the modern world, yet it nearly costs the earth, too. Medical hardware has raised the practice of healthcare but also raised expectations of what healthcare can accomplish.
All four of these categories of technology have disrupted the practice of healthcare and will continue to do so. Some technologies increase overall costs, others decrease it or have great potential to do so. As Christensen says, the solution to disruption can only be disruption. But the path to a future state of healthcare business bliss won't be straight, and it won't "just happen."
It will take a lot of work from many actors—IT vendors, medical device makers, government agencies, and most especially hospitals and healthcare systems—to bring about disruptive changes that lower healthcare costs while maintaining quality.
Besides, change never ends. What comes after the current disruption? More disruption.
Edward Prewitt is the Editorial Director of HealthLeaders Media.
