Disruptive change in healthcare

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The nature of technology means that new innovations are always shaking things up. Just as Christensen and colleagues wrote in the early s, startups and new entrants often drive disruption in healthcare. NEJM Catalyst recently surveyed healthcare executives, clinical leaders, and clinicians, who concluded that disruptive innovation in healthcare will come from beyond traditional organizations. A review of digital technology projects and collaborations agrees: startups offer higher promises of disruptive innovation.

While focused startups will bring innovation, those in the field agree that hospitals and health systems are the sectors most in need of disruption. Next on the list are healthcare IT, primary care, and pharmaceuticals. Disruption is happening everywhere in healthcare — from AI to mHealth to 3D printing and robotics.

Here are a few contemporary examples of disruptive healthcare technology:. These are just a few examples of technologies creating new markets and changing the way healthcare happens. In addition to technological innovation, experts say there are two processes that often facilitate disruption in healthcare specifically.

The first is decentralization. Disruption typically involves new market entrants creating products that bring in new consumers.

But in healthcare, everyone is already a consumer. Telemedicine is the most obvious example. This means transferring skills from highly trained, expensive personnel, to more affordable providers, including technology-based care.

This helps address expensive care due to overshoot of patient needs by health care institutions. Disruptive innovation is necessary, says Christensen , both for the healthcare industry and to improve patient care. What is disruptive healthcare technology?

Posted by Remy Franklin on September 10, Featured. Studies of these industries reveal two important facts about disruptive innovation: The change resulting from disruptive innovation has always been positive, leaving us with better products and services than before.

It is usually new entrants into the market that figure out a better way of doing things. Powerful institutional forces fight simpler alternatives to expensive care because those alternatives threaten their livelihoods. And those opponents to low-cost change are usually lined up three or four deep. Imagine for a moment that our entrepreneur was able to license the technology. Even then, he would probably face insuperable barriers. Regulators, afraid of putting patients at risk, would withhold approvals.

Insurance companies, which approve only established licensed procedures, would refuse to reimburse for it. And hospitals, with their large investments in radiology and emergency departments, want injuries to flow to them—so they, too, would join the forces holding back change. Quite the reverse—the health care industry desperately needs to open its doors to market forces. Make no mistake: the U. Prestigious teaching hospitals lose millions of dollars every year.

Health care delivery is convoluted, expensive, and often deeply dissatisfying to consumers. Managed care, which evolved to address some of these problems, seems increasingly to contribute to them—and some of the best managed-care agencies are on the brink of insolvency. We believe that a whole host of disruptive innovations, small and large, could end the crisis—but only if the entrenched powers get out of the way and let market forces play out.

In any industry, a disruptive innovation sneaks in from below. Over time, the simpler offerings get better—so much better that they meet the needs of the vast majority of users.

The top solid line depicts the pace of technological innovation—the improvement an industry creates as it introduces new and more-advanced products to serve the more-sophisticated customers at the high end of the market.

We call these sustaining innovations. The shaded area outlines the rate of improvement consumers can absorb over the same time.

The pace of sustaining innovation nearly always outstrips the ability of customers to absorb it. That creates the potential for upstart companies to introduce disruptive innovations —cheaper, simpler, more convenient products or services that start by meeting the needs of less-demanding customers.

The progress of these disruptive innovations is shown by the bottom solid line. Dominant players in most markets focus on sustaining innovations—on improving their products and services to meet the needs of the profitable high-end customers.

Soon, those improvements overshoot the needs of the vast majority of customers. That makes a market ripe for upstart companies seeking to introduce disruptive innovations—cheaper, simpler, more convenient products or services aimed at the lower end of the market. This phenomenon of overshooting the needs of average customers and creating the potential for disruption quite accurately describes the health care industry.

If we were to draw a graph to illustrate health care specifically, we would measure the complexity of diagnosing and treating various disorders on the vertical axis. The least-demanding tiers of the market are patients with disorders such as simple infectious diseases.

The most-demanding tiers include patients with complex, interactive problems such as an elderly man with a broken hip complicated by poor health from long-standing diabetes, hypertension, and heart disease—situations in which multiple systems of the body are involved, and cause and effect are difficult to disentangle. Our major health care institutions—medical schools, groups of specialist physicians, general hospitals, research organizations—have together overshot the level of care actually needed or used by the vast majority of patients.

Between and now, for example, our medical schools and residency programs have churned out specialists and subspecialists with extraordinary capabilities.

But most of the things that afflict us are relatively straightforward disorders whose diagnoses and treatments tap but a small fraction of what our medical schools have prepared physicians to do. Similarly, the vast majority of research funding from the National Institutes of Health is aimed at learning to cure diseases that historically have been incurable.

Much less is being spent on learning how to provide the health care that most of us need most of the time in a way that is simpler, more convenient, and less costly. General hospitals—especially teaching hospitals—have likewise overshot the needs of most patients.

Their impressive technological ability to deliver care enables them to address the needs of a relatively small population of very sick patients. But in the process of adding and incurring the costs of such capabilities, they have come to overserve the needs of the much larger population of patients with less serious disorders.

As the stand-alone cardiac care centers, outpatient surgery centers, and other focused institutions get better and better, they become the price setters. Last year not a single teaching hospital in Massachusetts made money. As a group, the medical schools, specialist physicians, hospitals, and equipment suppliers have done an exceptional job of learning to treat and resolve difficult, intractable problems at the high end.

We stand in awe of what they have accomplished. But precisely because of their achievements, health care is now ripe for disruption. Many of the most powerful innovations that disrupted other industries did so by enabling a larger population of less-skilled people to do in a more convenient, less expensive setting things that historically could be performed only by expensive specialists in centralized, inconvenient locations.

For example, in the s when people needed computing help, they had to take their punched cards to the corporate mainframe computer center and wait in line for the data-processing specialists to run the job for them.

Minicomputers and then personal computers were disruptive technologies to the mainframe makers. But minicomputers enabled engineers to solve problems for themselves that had required centralized computing facilities. And personal computers enabled the unwashed masses—less-skilled people like the rest of us—to compute in the convenience of their offices and homes.

Nearly every disruptive innovation in history has had the same impact. Photocopying enabled office workers to do things that historically only professional printers could do. On-line brokerages have made investing so inexpensive and convenient that even college students now actively manage their own portfolios. Indeed, disruptive technologies have been one of the fundamental mechanisms through which the quality of our lives has improved.

Our health care system needs to be transformed in the same way. Rather than ask complex, high-cost institutions and expensive, specialized professionals to move down-market, we need to look at the problem in a very different way.

Managers and technologies need to focus instead on enabling less expensive professionals to do progressively more sophisticated things in less expensive settings. Similarly, we need innovations that enable procedures to be done in less expensive, more convenient settings—for doctors to provide services in their offices that used to be done during a hospital stay, for example. As specialist physicians continue to concentrate on curing the most incurable of illnesses for the sickest of patients, less-skilled practitioners could take on more complex roles than they are currently being allowed to do.

And new procedures like angioplasty are allowing cardiologists to treat patients that in the past would have needed the services of open-heart surgeons. Teaching hospitals incur great costs to develop the ability to treat difficult, intractable illnesses at the high end. In the process, they have come to overserve the needs of the much larger population of patients whose disorders are becoming more and more routine.

Some innovations of exactly this sort have transformed pockets of the health care system, and where they have happened, higher quality, greater convenience, and lower cost actually have been achieved. Before , for example, patients with diabetes could only know whether they had abnormal levels of glucose in their blood indirectly; they used an often inaccurate urine test or visited a doctor who drew a blood sample and then measured its glucose content on an expensive piece of laboratory equipment.

Today, patients pack miniature blood glucose meters with them wherever they go; they themselves now manage most aspects of a disease that previously had required much more professional involvement. They get far higher quality care far more conveniently. No patient or professional pines for the good old days—even though the companies that made the large laboratory blood-glucose testers were all driven from the market, and endocrinologists now face significantly reduced demand for their services.

Angioplasty is another example. Before the early s, patients with coronary artery disease were treated through bypass surgery. It required a complex, technologically sophisticated surgical team, as well as multiple specialists in several disciplines, complicated equipment, days in the hospital, and weeks in recovery. The far simpler angioplasty uses a balloon to dilate narrowed arteries, causing less pain and disability.

It enables less expensive or specialized practitioners to treat more people with coronary artery disease in lower cost settings. Initially, angioplasty was used in only the easiest cases and was much less effective than surgery. But over time the disruptive innovation improved. Increasing skill and experience, together with sustaining technological innovations such as stents, have allowed angioplasty to supplant surgery in many cases.

By enabling less expensive practitioners to treat diabetes and coronary artery disease in less costly locations, these disruptive innovations have made health care more efficient. But more important, no compromises in quality were made. On the contrary, more patients get more care. When care is complex, expensive, and inconvenient, many afflictions simply go untreated.

Before the disruption of angioplasty, for example, many people with coronary artery disease were not treated. Patients had to be disabled with chest pain or at risk of heart attack to justify the expense and inconvenience of open-heart surgery. We need many more such disruptions—and today we have them within our reach. Unfortunately, the people and institutions whose livelihoods they threaten often resist them. We saw such resistance in the story of the portable X-ray machine.

An English entrepreneur has developed a system for customizing eyeglasses quickly and efficiently. The patient puts on a pair of eyeglasses with seemingly flat lenses and an odd-looking rubber bulb attached to each stem. Looking at a vision-test chart and covering one eye, she squeezes the bulb on the right stem until she can read the fine print on the chart.

A monomer in the bulb shapes the lens until that eye can see perfectly. She repeats the process for the other eye. This is a disruptive technology. It lets patients do for themselves something that historically required the skill of professionals. How might patients fare amidst health care disruptions? The answer depends on whether competitive markets are allowed to work efficiently. If clinicians or patients are forced to use less expensive technologies, disaster will result. But if consumers and providers are given choices, the use of disruptive technologies will migrate to those applications where they create real value.

Consider Sonosite, a Seattle-area company that makes a small, highly portable, inexpensive ultrasound machine. The machine is good, but it is disruptive—it lacks the analytical features and the degree of resolution found in more expensive ultrasound equipment. Ultimately, we would expect that the disruptive portable machines will improve to the point that they will supplant the more expensive traditional ultrasound equipment in established applications as well.

But the true transformative impact of such technologies in health care will come as they allow less expensive professionals to provide better care. If history is any guide, the established high-end providers of products and services are likely to be articulate and assertive about preserving existing systems in order to ensure patient well-being. Very often, however, their eloquence reflects concerns about their own well-being.

Customers have almost always emerged from disruptive transitions better off—as long as the disruptions are not forced into an old mode, but instead enable better service to be delivered in a less-costly, more convenient context.

Of course this is a reasonable concern. But it frames the problem incorrectly. Such resistance affects not only technology but people as well. Because of advances in diagnostic and therapeutic technologies, these clinicians can now competently, reliably diagnose and treat simple disorders that would have required the training and judgment of a physician only a few years ago. In addition, studies have shown that nurse practitioners typically devote more time to patients during consultations than physicians do and emphasize prevention and health maintenance to a greater degree.

The flawed rationale behind such policies is that because nurse practitioners are not as highly trained as physicians, they are not capable of providing care of comparable quality.

This is the same logic that minicomputer makers used to discredit the personal computer. Studies have shown that nurse practitioners with comparable training in simple infectious diseases can provide care of comparable quality in that tier of the market—even though they lack training in more complex disorders.

But family practice doctors recognize when they can treat a disorder and when it merits referral to a specialist. Surely nurse practitioners, working at even simpler tiers of the market, can be equipped to do the same thing. The real reason for blocking such disruption, we suspect, is the predictable desire of physicians to preserve their traditional market hegemony. They have forced highly trained physicians down-market to diagnose ear infections and bronchitis and have prevented nurse practitioners from doing things that technology enables them to do perfectly well.

The result of this policy is perverse. To maintain their incomes, primary care physicians are forced to churn patients at an alarming rate—frequently spending only a few minutes with each patient.

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A review of digital technology projects and collaborations agrees: startups offer higher promises of disruptive innovation. While focused startups will bring innovation, those in the field agree that hospitals and health systems are the sectors most in need of disruption.

Next on the list are healthcare IT, primary care, and pharmaceuticals. Disruption is happening everywhere in healthcare — from AI to mHealth to 3D printing and robotics. Here are a few contemporary examples of disruptive healthcare technology:. These are just a few examples of technologies creating new markets and changing the way healthcare happens.

In addition to technological innovation, experts say there are two processes that often facilitate disruption in healthcare specifically. The first is decentralization. Disruption typically involves new market entrants creating products that bring in new consumers. But in healthcare, everyone is already a consumer. Telemedicine is the most obvious example.

This means transferring skills from highly trained, expensive personnel, to more affordable providers, including technology-based care. This helps address expensive care due to overshoot of patient needs by health care institutions. Disruptive innovation is necessary, says Christensen , both for the healthcare industry and to improve patient care.

What is disruptive healthcare technology? Posted by Remy Franklin on September 10, Featured. Studies of these industries reveal two important facts about disruptive innovation: The change resulting from disruptive innovation has always been positive, leaving us with better products and services than before.

It is usually new entrants into the market that figure out a better way of doing things. Disruptive technology in healthcare In the early s, the healthcare industry was ripe for disruptive innovation. Where is disruption happening now? Examples of disruptive healthcare technology Disruption is happening everywhere in healthcare — from AI to mHealth to 3D printing and robotics.

In fact, there are already several examples of it taking place. For instance, consider how telemedicine is disrupting the traditional way that patients interact with doctors. With telemedicine, patients can now receive care from a doctor without having to leave their homes. This is thanks to the advent of technology that allows doctors to treat patients remotely via video chat or phone call.

Another example of disruptive innovation in healthcare is the rise of wearable health sensors. This data can then be shared with doctors, who can use it to help patients manage their health more effectively. The rise of telemedicine. This refers to the use of technology to provide medical care remotely. It allows patients to receive treatment from a doctor or other healthcare professional without having to visit a clinic or hospital.

Telemedicine can be used for a variety of purposes, including diagnosing and treating illness. Wearable health sensors are just one example of how technology is disrupting the healthcare industry. Other examples include:. All these examples show that disruptive innovation is happening in healthcare and that it is changing the way we think about and access healthcare.

Disruptive innovation in healthcare is happening at a rapid pace, and it is changing the way we think about and access healthcare. Here are some of the most disruptive innovations that will shape the patient experience in the years to come:. In addition to these trends, there are also a number of challenges that healthcare providers will need to face in the coming years.

One of these challenges is the growing cost of health care. In order to control costs, providers will need to find ways to provide high-quality care at a lower price. They will also need to find ways to reduce waste and improve efficiency. Another challenge facing healthcare providers is the increasing demand for services. Technology has disrupted various industries, including the way healthcare is delivered. The use of technology has allowed providers to deliver care more efficiently and at a lower cost.

In addition, it has allowed them to provide services to patients in a more convenient and affordable manner. As a result, disruptive innovations are likely to have a major impact on the healthcare industry in the years ahead. In order to stay competitive, providers will need to embrace these changes and find ways to incorporate them into their operations.

They will also need to find ways to adapt their services in order to meet the needs of their patients. By doing so, they can help ensure that they remain relevant.

The healthcare industry is in the midst of a major transformation. One of the driving forces behind this change is disruptive innovation. This term refers to innovations that disrupt existing industries and business models. They typically offer lower cost or more convenient options for consumers.

As a result, they often have a major impact on the way businesses operate. In the healthcare industry, disruptive innovations have led to changes in how providers deliver patient care. From the way we communicate to the way we get around, technology has changed the way we do just about everything. And healthcare is no exception. In fact, disruptive innovations in healthcare have led to changes in how providers deliver patient care.

They have also had a significant impact on what treatments are available and how people access them. Another example of disruptive innovation in healthcare is the rise of self-care. This involves people taking a more active role in their own health and wellbeing. It includes things like using apps to track activity or eating habits, as well as using online resources to find information about specific conditions.

Self-care has become increasingly popular in recent years, thanks in part to the growing number of wearable devices that allow people to track their activity and health data.