A groundbreaking prescription for health care reform--from a legendary leader 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 improve health 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 a range 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
If Washington Would Only Read and UnderstandMarch 9, 2010 Darryl K. Williams 1 out of 1 found this review helpful
I (St. Paul) have become all things to all people, so that I might by any means save some. I do it all for the sake of the gospel, so that I may share in its blessings. - 1 Corinthians 9:23
Willingness to be all things to all people may be a good strategy for spreading the Gospel, but it doesn't work in business including the business of health care. At least that is the way I would summarize the basic message of The Innovator's Prescription by Clayton Christensen, Harvard Business School Professor. It's a message that rings true with me based on personal experience in a company struggling with management of both specialty and commodity businesses. Christensen's focus is on disruptor-driven innovation, and he has applied the same theories to education reform in Disrupting Class.
Words analogous to those of St. Paul quoted above could well be uttered by general hospital managements and physician practices who would say something like this:
To those with serious life threatening injuries, we have become a trauma center so that we might save their lives. To those with bad colds, we have become a dispenser of aspirin and advice. To those with terminal illnesses, we have become very expensive anti-hospices doing whatever we can to prolong life. To those with chronic illnesses we have become providers of routine and ordinary treatments at high cost and great inconvenience. To those with undiagnosed illnesses we have become expensive providers of trial and error testing to try to figure out what is wrong. To those needing operations, we have become a surgery center. We do it all for the sake of health care so that we may share in the revenues available from it.
The problem with that lack of focus is that it assures a high cost structure and impossibility of providing such services efficiently or for charging appropriate and fair prices for them. Christiansen argues that there are three basic tasks to be provided to customers of the health care system and that the three are so different in nature that it is impossible for a single integrated institution to provide all three efficiently and effectively. In lay terms, I would say the three basic tasks are:
1. Diagnosis and problem solving
2. Application of standard one-time treatment based on the diagnosis
3. Ongoing management of chronic diseases
The first task requires the best specialized education and technology and is most expensive and can be paid for only with a fee for service system. Probably most people never need such service. The second task is process oriented and can be standardized with written procedures describing best practices. Such standardization will allow primary care physicians to displace specialists and nurse practitioners to displace primary care physicians for many tasks thus increasing availability and reducing cost and time required. Pay can be based on results. The third task is best managed by facilitated networks of persons with the same diseases to enable sharing of best practices and improve communication and access while reducing costs. Pay can be based on participation.
Christensen discusses the normal business development cycle that begins with evolution of vertically and horizontally integrated companies at the front end followed by a process of dis-integration as those big companies gradually outsource the least value adding parts of the business to smaller companies. All the steps in that process make economic sense for the large company giving up something, for the small company gaining something, and for the customer getting a better deal in cost and quality. This cycle is playing out in small ways in the health care industry such as in development of independent surgery centers and nurse practitioner staffed retail clinics but is severely slowed and restricted by the government imposed system of fixed reimbursement for procedures. Physician practices and general hospitals are helpless to change the system because they are trapped in it and dependent on it. Rapid change must come from external disruptors.
He also discusses a normal technology development cycle which begins with everybody having to go to experts to access a new technology and proceeds to wide dispersion of and easy access to the technology even for novices. A medical example cited is Dialysis, which is now so simple that it can be done at home more effectively and at lower cost but normally is not because congress guarantees Medicare reimbursement for clinical dialysis for anyone suffering from end stage renal failure.
This is a rich text, full of examples from medical and non-medical businesses, to which I cannot do justice in a post of a few hundred words. For any who believe that a government single payer system is the best approach for US health care, this text will explain clearly why smart people who have spent years studying the system think otherwise.
I offer this quote from near the end of the text:
We hope, however, that the concepts in this book can give government officials a language and a deeper understanding of how the world works, so they can sort self-serving arguments from public-serving ones. In particular, we hope we've provided convincing theory and evidence that the solutions cannot come simply from demanding that existing providers operate more efficiently or compete against each other more intensely...The health-care industry needs to be disrupted.
Now, if government officials would only read the book...as soon as they get through reading the self-serving argument based 2000+ page bill that they are about to pass and try to implement.
Outstanding look at healthcareNovember 24, 2009 Michael Monson(NY, NY) 1 out of 1 found this review helpful
This book is a must read for anyone in the healthcare field. It is a manifesto of change for our sector
Excellent analysis and a model for building a solutionOctober 30, 2009 R. Brush 1 out of 2 found this review helpful
The Innovator's Prescription is an excellent analysis of the systemic problems we see in health care in the United States. It makes a compelling case for managing health (versus managing illness), and applies Christensen's "Disruptive Innovation" model to point us down a path to help solve this.
As a lay person I didn't realize how ignorant I was regarding broader health care issues until I read this book. Highly recommended for anyone looking to better understand the problems and possible solutions.
A Must ReadAugust 2, 2009 Joseph H. Schneider The Innovator's Prescription: A Disruptive Solution for Health Care
This book explores the problems with the US health "system" and offers some disruptive solutions. Excellent
Solutions for healthcare that are both brilliant and disruptive!June 26, 2009 Arden Brion(Sylvania, OH United States) 2 out of 3 found this review helpful
Well researched and compellingly reasoned, "The Innovator's Prescription" is exceptional medicine everyone should be taking, especially those in Washington. The book's systemic view of the current state of healthcare industry is absolutely brilliant as Christensen, Grossman and Hwang apply their "disruptive innovation" vision to the future of healthcare.
Most compelling are the book's foundational assertions that the general hospital is not a viable business model because it mixes three types of business models under the same roof, and consequently, cost problems are due to overhead, and quality problems are due to poor integration.
Truly provocative thinking at its best. Two thumbs way up!
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