Managed Care - January 2009 - (Page 12)

n 1995, Harvard business school professors Innosight Institute, a not-for-profit think tank. Clayton Christensen and Joseph Bower put “Disruptive innovations, like we’ve seen in other “disruptive technologies” in the business industries, can bring complex and expensive health lexicon by introducing the term in a semicare products and services to greater levels of afnal article in the school’s journal. fordability and accessibility,” Hwang says. The phrase described what happened in 1960, for The essence of the authors’ thesis is the view that example, when an unknown company, Sony, began America’s entire delivery system must change radselling an affordable transistor television that evenically, adding lower-cost providers and lower-cost tually replaced RCA’s vacuum tube. venues. General hospitals and physician practices, Soon it became apparent the transistor alone — the two dominant models in health care, are inefthe disruptive technology — did not tell the whole ficient and do not produce perfect results, they sugstory. To achieve success, the technology had to be gest. With the help of technology, some medical coupled with a whiz-bang business plan, giving care can be transferred from specialists to generalbirth to the encompassing term “disruptive innoists, from generalists to nurses, then to allied health vations.” Sony, with its coveted transistor TV that professionals, and ultimately to patients themselves. many people could afford, and a plan to sell its TVs It may not require a board-certified family practhrough Kmart, then a new retitioner or internist to detertail chain, put both the more mine whether a sore throat must expensive RCA vacuum tube be treated with antibiotics since TVs, as well as the many momthe rapid strep test is a proven and-pop appliance stores that technology that can be used by refused to sell Sony sets, essenother health care professionals. tially out of business. And it isn’t hard to imagine that Christensen has since writsince diabetics and patients with ten or co-written seven books clotting disorders now have the on disruptive innovations, technology to test and inject using the term to suggest how themselves routinely, people to mend problems in the worlds with other chronic conditions of business and education. could be taught to monitor and They illustrate how upstarts control their diseases in a simiusing new technology can lar manner. change an industry to make our Christensen and his coBy Maureen Glabman lives better. authors support single-organ Contributing Editor But for the 56-year-old Salt hospitals, such as the 55-yearLake City-born economist, a Rhodes Scholar who old Shouldice Hernia Centre in Ontario, because served as a Mormon missionary, speaks fluent Kothe same operations are performed repeatedly, prerean, and became a Harvard PhD student at 40 cisely, and less expensively than by general hospiwith five children, his toughest challenge was to tals. A hernia repair at Shouldice is about $2,300, apply successful business concepts to solve the verses $7,000 at a general hospital in the United problem of vexing runaway health costs. States. As a further trickle down, complex work previously done at hospitals can be accomplished at outpatient diagnostic centers, ambulatory surBetter and cheaper gical centers, urgent care clinics that serve as low He teamed up with two prominent physicians acuity emergency rooms, and remotely by using and spent 10 years dissecting and pondering the videoconference technology and robots. Some surissue. The result is The Innovator’s Prescription (Mcgical robots, such as modern LASIK machines, can Graw-Hill, 2009), co-written by the late Jerome operate themselves, and this will become more Grossman, MD, a founder of Tufts Associated common. Health Plans and former CEO of Tufts Medical “We already recognize that a lot of care takes Center, and by Jason Hwang, MD, MBA, an inplace in ambulatory settings today that would have ternist and co-founder with Christensen of the I Disruptive Innovations That Will CHANGE Your Life in Health Care 12 MANAGED CARE / JANUARY 2009

Table of Contents Feed for the Digital Edition of Managed Care - January 2009

Managed Care - January 2009 Editor's Memo Contents Legislation & Regulation News and Commentary Medication Management Compensation Monitor Health Care's Disruptive Innovations Q&A With Clayton Christensen 'Disruption' May Be Plans' Best Bet Avoid the PBM Rebate Trap HealthPartners Puts Diabetes on Notice Formulary Files Plan Watch Tomorrow's Medicine Ad Index Outlook Unmet Needs in the Management of Plaque Psoriasis Impact of RSV: Implications for Managed Care

Managed Care - January 2009

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