The Innovator's Prescription: A Disruptive Solution for Health Care

Clayton M. Christensen · Jerome H. Grossman · Jason Hwang

Oct 2008 · McGraw Hill Professional

About this ebook

A groundbreaking prescription for health care reform--from a legendaryleader in innovation . . .

Our health care system is in critical condition. Each year, fewer Americans can afford it, fewer businesses can provide it, and fewer government programs can promise it for future generations.

We need a cure, and we need it now.

Harvard Business School’s Clayton M. Christensen—whose bestselling The Innovator’s Dilemma revolutionized the business world—presents The Innovator’s Prescription, a comprehensive analysis of the strategies that will improvehealth care and make it affordable.

Christensen applies the principles of disruptive innovation to the broken health care system with two pioneers in the field—Dr. Jerome Grossman and Dr. Jason Hwang. Together, they examine arange of symptoms and offer proven solutions.

YOU’LL DISCOVER HOW

• “Precision medicine” reduces costs and makes good on the promise of personalized care
• Disruptive business models improve quality, accessibility, and affordability by changing the way hospitals and doctors work
• Patient networks enable better treatment of chronic diseases
• Employers can change the roles they play in health care to compete effectively in the era of globalization
• Insurance and regulatory reforms stimulate disruption in health care

Ratings and reviews

According to the author, the current state of the health care industry is not unlike other heavily regulated industries before it, such as telecommunicationsand transportation, where initially providers were centralized and services were affordable only by the higherincome segment. In each case, it was not deregulation that led to change but disruptive innovation that followed it. So the premise of the book is that health care reform cannot be achieved without disruptive innovation, and that this is mutually exclusive with a single payer model. Instead, what is needed is for disruptions in technology, business models, and value networks to act in concert to remodel the health care system. In order to allow new entrants that can disrupt existing networks and shift the sites of care from centralized to decentralized and the personnel for delivery from specialized to less specialized, there must be a heterogenous system tied together by electronic health records. The current state of the industry is mired in centralized mixed business models that need to be separated into three types of businesses: "fee for service" solution shops that work heuristically with incomplete information to diagnose and treat disease ("intuitive medicine"), "fee for outcomes" value added process businesses that emphasize efficiency and repeatable results ("empirical medicine"), and "fee for membership" disease management networks that emphasize compliance ("precision medicine"). Right now the general hospitals have a mix of all three but still charge everything on a fee for service basis because of reimbursement policies. This has led to excessive overhead burdens on what should be "fee for outcomes" or "fee for membership" types of services. By separating these business models into separate corporate entities they can optimize their performance and value networks. The author also cites the contrast of integrated health systems such as Kaiser and Geisinger which by use of electronic health records and fee for outcome measurement can achieve much greater efficiencies, and can engender their own disruptive innovation internally because of their ability to capture the benefits. Overall then, in order to lower the rate of cost increases in health care while maintaining quality and increasing choice, the prescription is to encourage disruptive innovation in technology and business models that enable decentralization of care and use of less specialized personnel, tied together by electronic health records to capture the outcomes data.

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About the author

Clayton M. Christensen is the Robert and Jane Cizik Professor of Business Administration at the Harvard Business School. Christensen is also co-founder of Innosight, a management consultancy; Rose Park Advisors, an investment firm; and Innosight Institute, a non-profit think tank. He is the author or coauthor of five books including the New York Times bestsellers The Innovator's Dilemma, The Innovator's Solution and most recently, Disrupting Class. He alsoserves as a leader in the Church of Jesus Christ ofLatter-day Saints.

The late Jerome H. Grossman, M.D., was the Director of the Harvard/Kennedy School Health Care Delivery Policy Program. A nationally recognized health care policy expert and a pioneer in health informatics, his leadership spanned business and health care. He served as CEO of a major medical center, chaired the Federal Reserve Bank of Boston, and co-founded four successful companies.

Jason Hwang, M.D., is an internal medicine physician and senior strategist for the Healthcare Practice at Innosight LLC, an innovation and strategy consulting firm. He also co-founded and serves as the Executive Director of Healthcare at Innosight Institute, a non-profit social innovation think tank. Previously, Dr. Hwang was a chief resident and clinical instructor at the University of California, Irvine. He received his M.D. from the University of Michigan and M.B.A. from Harvard Business School.