The Four Characteristics of Disruptive Healthcare IT Solutions
This week I was in the home of the father of disruptive innovation, Professor Clayton Christensen. At ACT.md we’re fortunate to have unique access to Professor Christensen as an Advisor and Board Member. As I sat across the dining room table from him, my question was simple, “when do you think we’ll see meaningful disruption in healthcare?” As an entrepreneur in healthcare, a manager focused on doing the job of care, and a student learning the lessons of other companies and industries, there were many layers to my question. Clay leaned back, smiled and said, “Well, Ted, how much patience do you have?”
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Over the past several years, healthcare reform has required providers to make significant investments in information technology with the ultimate goal of improving the quality of care and reducing cost. The initial technologies developed and adopted were designed to digitize patient records for data capture and sharing, now known as Electronic Health Records. EHR’s enable healthcare organizations to meet requirements of Meaningful Use; with these tools there is better access to a patient’s medical history, reduction in errors with computerized order entry, and increased charge capture. I’ll call these v1.0 healthcare IT solutions
While there are benefits as I outlined above, unfortunately, the spread of EHR technology has brought unintended consequences. Clinicians now spend a significant amount of time each day at a terminal documenting their work into the medical record for the purposes of billing and meeting these regulatory requirements. While the intent behind the rulings is positive and providers must get paid, unfortunately, it’s led to less time providing direct patient care and has made clinical teams very dissatisfied.
This is driving the emergence of a new era of healthcare information technology. New solutions, which I call v2.0 healthcare IT solutions, have been developed and are gaining traction; they are uniquely positioned to disrupt the current leaders in the marketplace. To use an analogy from Clay, these are the mini mills of healthcare poised to fundamental change the marketplace. A key question for payers, providers, and patients is, “how can I identify these tools which fundamentally will change healthcare?” Let me suggest four characteristics, which will help buyers identify these emerging platforms:
- Disruptive solutions are simple, targeting a key job of care delivery. V1.0 healthcare IT solutions are complicated; they are difficult to set-up, maintain and require significant training to operate effectively. I will never discount the complexity in healthcare delivery, however in Clay’s words “simple solutions to complex problems are what lead to breakthroughs in industries”. Disruptive innovations are purpose-built and straightforward: easy to implement, intuitive to use, and focus on a specific need of patients and providers , which is poorly supported. For example, we’ve seen companies emerge in healthcare focused exclusively on how a referral happens from provider-to-provider. A very simple task, but surprisingly difficult to execute, track, and measure in the v1.0 environment. Disruptive solutions tackle these simple, sometimes mundane, activities and fundamentally change the care experience for all parties.
- Disruptive solutions create new economic opportunities. Healthcare organizations are investing billions of dollars in v1.0 technologies, which require significant ongoing expense and investment. Here in New England, we have a healthcare organization spending over $1 billion on a new HIT solution across their system; this is the status quo, which our country can’t sustain. Disruption introduces a new economic model and cost curve. Pricing truly aligns with value, risk associated with results, and combined with price points that scale with care delivery. Not only are v2.0 solutions affordable, but they also bring new opportunities for reimbursement.
- Disruptive solutions are convenient, leveraging new technology. I have yet to hear a provider describe for me the “convenience” of their EHR. This is not meant to be a criticism of EHRs; it is just a reality that these v1.0 healthcare technology solutions were built on older technology platforms making it very difficult to mobilize, navigate, and be flexible. Disruptive solutions leverage new technology and modern paradigms of interaction, aligning to care team workflows and bringing convenient solutions to patients and providers that feel familiar to technology they use in their daily lives.
- Disruptive solutions are interoperable. Today’s commercial EHRs have their roots in practice-management billing systems, and over time vendors have tacked on additional modules – documentation, tasking, imaging, and order entry tools for clinicians. Since each EHR product has been built as an isolated silo, the ability for them to innovate and change quickly is very challenging and costly. Companies are trying to re-purpose or re-implement older software, which is causing additional problems for healthcare consumers. Disruptive solutions are built with an open infrastructure that allows for the ability to easily integrate and share information in a cost-efficiently and timely manner. With this, innovation can flourish as companies work to provide the best products for specific needs yet have the ability to easily integrate for the most seamless experience for patients and providers. These v2 solutions allow providers and patients to quickly change and adapt based on evolving technology or care requirements.
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There are key considerations to acknowledge with disruption in any industry. Adopting disruptive technologies or products requires some organizational change, therefore there needs to be an openness to this change. We are realistic that these new solutions often require changes to provider workflows and organization structure; however, the net result of these disruptive innovations will be the realization of the quadruple aim of healthcare.
It’s important to remember that disruption in healthcare is a positive force. Disruptive innovations in healthcare are not breakthrough technologies that make good products better; rather, they are new innovations that make care and services more accessible, affordable, safer with better outcomes, and align with our lives today. It will take time, but the cadence and pace of change is accelerating in healthcare and stage is set for welcomed disruption.
