The Innovator's Prescription

 The Innovator’s Prescription, A Disruptive Solution for Health Care, by Clayton M. Christensen, Dr. Jerome H. Grossman and Dr. Jason Hwang, McGraw-Hill 2009 

This is a milestone book because it combines the medical training and experience of its three co-authors with a fierce belief that disruption is what will change and possibly cure our dangerously fragmented healthcare “system.”  What makes this book more poignant, however, is that later Christensen himself tripped into the system, a story he tells in How Will You Measure Your Life?                           .

By applying the same disruptive view applied to technology, the authors take a look at the broad spectrum of healthcare industry work areas – technology, information flows, the role of employers, process flows, and insurance and regulatory reforms.  The opportunity areas are so many, however, even after publication of this landmark book, healthcare thinkers and reformers like Dr. John Toussaint, still find it difficult to select only one or two pressure points to work on.

Nevertheless, The Innovator’s Prescription authors have narrowed the field down to a workable few.  Technology fans will like their coverage of how technology breaks open and industry with the potential to radically affect outcomes.  In fact, however, they caution readers:  “The health-care industry is awash with new technologies – but the inherent nature of most is to sustain the current way of practicing medicine….  The technologies that enable precise diagnosis and.. predictably effective therapy area those that have the potential to transform healthcare through disruption.”  

 The move from intuitive or experienced based medicine, to precision medicine may be puzzling to non-healthcare professionals, but the timeline and stories illustrate well what the authors believe is happening in this area.  Diseases like TB, diphtheria, cholera, malaria, measles, scarlet fever, typhoid, syphilis, polio, yellow fever, smallpox and whooping cough once accounted for a majority of healthcare costs, but now, precise diagnoses have enable effective treatment.  To get to this kind of precision – just as auto makers have improved their design to manufacture cycle from a rubber mallet and a two-by four (see Steven Wheelwright Target magazine) to consistent and perfect CAD/CAM design transmitted instantaneously to manufacturing – requires both disruptive technologies, and the management environment. 

Is healthcare now at the point where humans can push technology and Big Data to good results?  We’ll have to see how far we go, but now that government reform proves to be yet another disruptive force, it will be difficult to translate great policies from big thinkers into predicable and excellent healthcare results.  Although The Innovator’s Prescription appeared in 2009, it’s clear that we haven’t moved too far away from the authors’ prescription to still have a shot at change.  What the authors recommend is strong medicine, best not delayed.  The process of taking us through their statistics and industry examples, however, is what works well for current readers looking for a new integrated vision of healthcare.