Innovation Discussion at WHCC

We are just starting the 4th general session here.  [This is harder to do real-time blogging than I thought…and keep paying attention.]

The panel is Toby Cosgrove from the Cleveland Clinic, Grant Harrison from Humana, and Lee Shapiro from AllscriptsJustin Fox from Time and Clayton Christensen from HBS are the moderators.

Clayton is talking about disruptive technologies:

  • There is one line for performance that customers can utilize or absorb which has a moderately upward slope.  There is a higher sloped line which indicates the pace of technological progress.
  • Incumbents nearly always win when it is a sustaining innovation.
  • Disruptive technologies start with a technology that is not as sophisticated and less expensive then improve until it meets the market demand.  In these cases, new entrants usually win.  (e.g., PC versus mainframe)
  • Hard for companies to pursue disruptive technologies due to the pursuit of profits.  (Toyota started in US with Corolla and only eventually moved to Lexus.)
    • Koreans now doing this to Toyota.
  • 3 enablers of disruption:
    • Technological
    • Business model
    • Commercial system
  • Focus of enablers in healthcare:
    • Movement from specialist to family MD to nurse to parent
    • Movement from general hospital to focused hospital to outpatient clinic to office to home
  • He talked about the movement from intuitive medicine to empirical medicine and eventually to precision medicine (precise diagnosis by cause not by symptoms).

Toby Cosgrove is now talking:

  • Clayton’s model is right.  Gave example of moving from surgery to drugs to prevention.
  • Talked about work being done around using technology to address Parkinson’s disease.
  • Innovation is only answer to affordability challenge.

Grant Harrison from Humana:

  • Absolutely focused on innovation within Humana.
  • Focused on changing things for consumers.  What do they want?  What do they want improved?  What is health mean to them?
  • Research says health means being able to do what I want to do with my life…So how are people living their lives.
  • How does this change what we provide?
  • The end goal is happiness not just elimination of disease.

Lee Shapiro from Allscripts:

  • EMR plays a substitutive role for paper chart.  It is transformative is the ability to introduce evidence-based rules and connect providers with information that they need and other services and providers that are important to care.
  • Talks about their web-based e-prescribing tool used by thousands of MDs.  [Indicative of how slow adoption is happening.]

Clayton  says  that today’s hospitals and specialist practices are agglomerations of three business models he talks about which include solution shops, value chain, and facilitated-user network model.  When we separate those out into distinct models, then the value can be assessed and priced appropriately.

  • MD value prop: the solution to any problem starts here. (solution shop which over-prices for basic acute disorders by its design.
  • Clinic value prop: fast, convenient resolution of rules-based acute disorders.

Clayton showed an interesting slide mapping (X) the role of the patient and family’s intuition in effective therapy versus (Y) the important of MD’s intuition.

  • Bottom left has diseases that fit a clinic – GERD, myopia, HIV, migraines.

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