Disruptive Innovation in Health Care: Identifying Areas of Future Growth

Transcription

1

2 Disruptive Innovation in Health Care: Identifying Areas of Future Growth Jason Hwang, M.D., M.B.A. Executive Director, Healthcare

3 The Disruptive Innovation Model Incumbents nearly always win Time Sustaining innovations Pace of Technological Progress Performance that customers can utilize or absorb Disruptive innovations Entrants nearly always win Performance

4 Disruption is driven by an asymmetry of motivation Incumbents nearly always win Sustaining innovations Performance 45% on $250,000 60% on $500,000 Time Different measure Of Performance 40% 20% on $2,000 Disruptive Innovations Entrants nearly always win Time Non-consumption

5 The growth of angioplasty 1,400 1,200 Estimated Inpatient Cardiovascular Procedures, s of procedures Balloon Angioplasty/Stenting CAGR % 1, Bypass 1.51% Source: United States Centers for Disease Control and Prevention National Hospital Discharge Survey; Innosight analysis.

6 Asymmetries of motivation in angioplasty High Complexity of diagnosis and treatment Low Cardiac Surgeon Cardiologist General Medicine Time When angioplasty was introduced, it captured the imagination of cardiologists and surgeons differently. Surgeons were skeptical about this new procedure. They were used to seeing small arteries in the operating room and questioned how one would be able to introduce a small catheter into the femoral artery, negotiate it via the left main coronary artery into a distal vessel, and dilate it. Cardiologists saw this as an incredible opportunity to treat patients with ischemic heart disease. Chief, Division of Cardiothoracic Surgery, Miami, Florida

7 Centralization followed by decentralization: Computing

8 Centralization followed by decentralization is common Long-distance telecommunication Higher education Music recording & distribution Movies / video Retailing

9 Decentralization is disruptive, and is hard to catch Sustaining innovations Performance Time Disruptive Innovations Time Non consumers: Targets for New Market Growth

10 The decentralization that follows centralization is only beginning in healthcare Specialty care Laboratory services Imaging services Clinical research and training Data collection and warehousing Non consumers: Targets for New Market Growth in Health Care? In Pathology? Surgical suites

11 The pursuit of profit and differentiation in head on competition among similar business models adds functionality and cost Disruptive decentralization is the mechanism that reduces cost and spurs widespread adoption

12 Information as a Disruptive Technology Disruption is not just about minicomputers, steel mills, and vacuum tubes

13 Disruption is facilitated when historically valuable (and expensive) expertise becomes commoditized Imaging & molecular diagnostics Experimentation Intuitive & Medicine problem solving Probabilistic Empirical Pattern Medicine Recognition Precision Rules Based Medicine

14 Electronic Health Records and the Medical Home Specialized solution shops (fee for service) Employernegotiated pricing Focused value added process clinics (fee for outcome) Retail clinics (fee for outcome) Personal electronic health record Primary care physicians Pharmacists User Networks (fee for membership) High deductible insurance & health savings accounts

15 Electronic Medical Records: Organizing Principles Must help users do a job that they re trying to do. Records themselves create no value they sit on a disk drive instead of in a file drawer. Patients and providers need to pull the records into use. If EMRs are pushed upon them they will not be used. Data must be open source, readable by all. Proprietary applications that help patients and providers do the jobs they need to do can then be built upon the data. Problems must surface before the problems can be solved. Interoperability problems, in particular, will be resolved only after they are encountered.

16 Market Understanding that Mirrors how Customers Experience Life The customer rarely buys what the company thinks it is selling him Peter Drucker

17 When jobs overlap, products and services will converge The jobs of cell phones and PDAs Why financial service firms are interested in your health LIS, RIS, and PACS will converge Radiology and Pathology will converge

18 The substitution of one thing for another always follows an S curve pattern % new % new % old

19 Past and Future Substitution of HSAs & HDI for Conventional Private Health Plans

20