Guest Post: The innovator’s Rx for health care

Photo courtesy of Stuart Cahill

by Clayton M. Christensen and Jason Hwang

It’s strange to think that not long ago, the ability of ordinary people to access a blog like this from a PC, laptop or cell phone was the stuff of science fiction. But the advent of the microprocessor, which simplified computer design and assembly, brought computing out of corporate mainframe centers and into our homes.

The microprocessor was what we call a “technological enabler” of disruptive innovation. Translation: It revolutionized the computer industry by making products cheaper and more convenient.

We’ve studied these innovations in another industry, health care, over the last 10 years. Many technological enablers — in the form of molecular diagnostics, imaging technologies, and myriad drugs and devices — exist in health care. Yet, lower cost and convenience haven’t come.

With our new President now focusing on health care, it’s time to look at why the system seems so broken, and to ask why health care isn’t following the pattern of the computing industry.

Actually, disruption is occurring, but often it’s outside of hospitals and physicians’ practices. These niches can show us how health care might become more affordable and convenient.

First, retail. As we describe in our new book, The Innovator’s Prescription, CVS Caremark’s (CVS) MinuteClinic provides basic care at kiosks in retail pharmacies. These clinics are staffed by nurse practitioners who can administer rules-based diagnostics and predictably-effective treatments like immunizations, strep throat exams and diabetes screenings.

Second, digital data. President Obama’s new budget puts big money behind digitizing medical records — a step toward making health data more accessible to both providers and patients. But in the private sector and apart from hospitals, Google (GOOG) Health and Microsoft (MSFT) HealthVault are already helping patients manage their clinical data by making user-generated health records portable.

Companies are also building online resources to allow patients to review health care providers. Zagat, known for its user-generated restaurant reviews, is partnering with WellPoint (WLP) to build a website that rates physicians.

There is also the giant challenge of disrupting the fee-for-service payment model, which general hospitals and private practices were built on. They profit from patients needing more services, more care, more time in the hospital, and more visits back to the doctor. In other words, they profit only when people are sick. What’s the incentive to provide the excellent, low-cost care that technological enablers make possible?

Here disruption comes from innovative providers like Kaiser Permanente. These providers want to give the best care at the lowest cost because they employ their own doctors and operate their own insurance companies. Their patients pay fixed fees for full services over a given time frame. These providers win by keeping their members healthy and satisfied with their care.

So, get ready, doctors and patients. Disruption is coming soon. And it’s a prescription we all need.

Clayton M. Christensen is the Robert and Jane Cizik Professor of Business Administration at Harvard Business School and co-founder of Innosight and Innosight Institute. Jason Hwang, M.D., is Senior Strategist for the Healthcare Practice at Innosight and Executive Director of Healthcare at Innosight Institute. They are coauthors, with the late Jerome Grossman, M.D., of The Innovator’s Prescription: A Disruptive Solution for Health Care.

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I received this in an email and would like to passit on.
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The Easter Bunny has Cometh

One day the nation woke up to sirens, horns, hoopla and shouting. The Easter Bunny was here! The Easter Bunny was here! People were confused but went back to daily living as the noise died down. As people went about their normal shopping, they were amazed that all the shelves of all the food stores had nothing but EGGS. Pretty eggs. All sizes. Lots of them. Most eggs were white. The rest were a rainbow of pretty colors. They checked restaurants and fast food places – nothing but eggs. They called long distance friends and relatives. It was the same all across the nation.

A frail, old woman picked up a large, pretty egg and went to pay for it. She was asked for “proof of age”. She didn’t question why and showed her drivers license. “Sorry mam. You can only have an egg with the number 73 on it.” She went back and looked for another large egg with the number 73 on it but all the eggs with a 73 on it were itsy bitsy ones. Being hungry, she picked two up but was told only one to a customer. She grumbled but paid for it and left. An orphan came in and pick up a small egg splashed with colors. When she went to the checkout, she said she couldn’t pay for it. She was asked for proof of age but didn’t have any. “That’s all right. I’ll decide how old you are. Go pick out a big, white egg with the number 10 on it and the Easter Bunny will pay for it.” A man came in and grabbed the biggest, prettiest egg he saw. He had difficulty at the checkout because he could only comprehend Spanish. After talking with a translator, he was told to pick out an egg with the number 29 on it and the Easter Bunny would pay for it. Another person came in, saw the eggs and tried to walk right back out. “No. No. You must pick out an egg with your age on it before you leave. If you can’t afford it, the Easter Bunny will pay for it.”

When the people got home, they noticed their eggs were not “real”. They were plastic. Inside, they found a categorized list of general healthcare benefits that MIGHT be available if they ever needed healthcare. The lists got shorter as the eggs got smaller. At the bottom of each list was a phone number to call if there were any questions. All the eggs had a government number to call. The colored eggs also had an insurance company number to call. On the back of the list were additional instructions to go to the nearest hospital to get a National Healthcare ID.

A lot of people, like the frail, old lady, never turned the list over. A week later, she developed a cough. When she called her doctor, he told her she needed a NHID before he could see her and that she could go to any hospital to get one. By the time she got her NHID, she had bronchial pneumonia. The young Hispanic man may have been poor but he wasn’t dumb. He got his NHID and quickly made appointments with three specialists to treat minor complaints. After all, his friends told him, it’s legal and the Easter Bunny was paying for everything. The frail old lady finally made it to the doctor who gave her a diagnostic note with a treatment code on it and told her to take it to the hospital. At the hospital, she eventually got to a receptionist who entered her NHID into a computer. The receptionist told her to come back in two months. Two months later, a neighbor carried her into the hospital. She finally got to the receptionist again. The receptionist queried her computer and said “You can have some pills, waiting for you in the hospital pharmacy now, or you can go home. It’s your choice.”

All of this could be yours courtesy of the 3,000,000 additional government bureaucrats needed to run your new National Healthcare Department which will be created to efficiently track, manage, adjust and decide your healthcare benefits, along with 310,000,000 others, at every stage of life.

HR 3200, if passed, does not say this will happen. It merely ensures that it is entirely possible. It is up to the bureaucrats how to “make it so”. Do you trust your government enough to NOT surprise you some morning with all the shelves of all the supermarkets across the nation filled with plastic eggs?

(Author unknown)
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Posted By Robert Bennett, Loudon, TN 37774 : August 22, 2009 12:29 pm

Lots of good examples here and I would add Practice Fusion – the first Web based Electronic Medical Records application available to Health Care Professionals for free and supported via corporate sponsorships. There is a subscription based, ad-free version as well. Good Health Advertising is the sales partner.

Robert Kadar, CEO
Good Health Advertising
http://www.GoodHealthAdvertising.com

Posted By Robert Kadar, NY, NY : March 4, 2009 1:36 pm

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