Disruption surrounds us – in technology, in healthcare, and not surprisingly, in healthcare technology. It is hard to predict and harder to control. “The Innovator’s Dilemma” and “The Innovator’s Prescription” by Professor Clayton Christensen and colleagues describe and advocate for disruptive innovation in the broad economy and in healthcare.
The iPhone disrupted the BlackBerry® which in turn disrupted the basic cell phone and Rolodex. The Kindle disrupted bookstores. The cloud disrupts client-server computing and brick and mortar businesses. Twitter enables actual revolutions and Uber changes the role of taxi dispatchers. At the heart of these disruptions are the Internet, GPS, Moore’s Law (computing power doubles about every two years), and exponential growth in data storage.
Healthcare faces powerful disruptions, driven by market forces, economics and demography, and regulation. The buzz words are familiar – accountable care, ACOs, an aging population, the rise of chronic disease, ICD-10 and SNOMED, Meaningful Use, government budget pressures, payment cuts and payment reform, patient engagement, and consumerism.
Healthcare IT product definitions blur as we move into more modular and app-based software and services. The definition of “electronic health record” become hazy with technology evolution and changing regulatory definitions, such as modular certification for “Certified EHR Technology”. Interoperability is more critical as existing and new types of applications need to connect with EHRs and each other, with an increasing focus on analytics and data liquidity. Tablets and mobile apps redefine workflows and how we interact with data and IT systems.
Some celebrate disruption as an end in itself; others are more neutral, and many, understandably, see it as a threat to their businesses and organizations (or just one more complication in their lives).
Disruption is inevitable, accelerating, and to be both embraced and managed carefully. It seems odd to think that disruption can be managed but that is the challenge we and our customers face. A product, business or industry may face a disruptive challenger whose success could benefit consumers. At the same time, we remain obligated to protect and advance the goals of our organizations and our shareholders and/or stakeholders.
With my teammates, I recently visited GE’s new Global Software Center in San Ramon, CA. We had great presentations on GE’s work in user experience, the Industrial Internet and new ways to think about integrating technology with services. We heard insightful discussions of cloud computing, technology platforms and the rise of apps and modular software. We also reviewed Agile software development, which involves iterative and incremental development, responsiveness to change, and close collaboration with users.
As a proud GE Healthcare employee I am struck by how this large company recognizes, embraces, and drives disruption, inside and outside, while also meeting our customers’ needs. At a product level, our new Universal Viewer reflects the value of using Agile techniques to develop innovative software that solves emerging customer problems.
GE is constantly reinventing itself while holding to core principles – performance, productivity, and growth. We are both embracing and managing disruption. For healthcare professionals and organizations, dealing with disruption is no less challenging and its management no less essential. The key is to be realistic, flexible, and disciplined; to define and hold to core principles; to understand fundamental market drivers; to adapt Agile approaches; to try to be the disrupter and not the disrupted; to recognize when disruption is inevitable; and to be rigorous in evaluating new technologies and their value, whether based in servers or the cloud.
Finally, disruption should not be a fetish. Not all disruptions are equally valuable; the market is our best guide to what should be adopted. Policymakers and regulators, vendors, and providers each should realize that there is a cost to disruption, especially in healthcare, where large capital investments with multi-year time horizons are common and predictable systems are needed to ensure delivery of safe and high quality care.
So let’s enjoy and take full advantage of our smart phones, tablets, and apps while staying focused on how we best meet our shared responsibilities to patients, their families, and other healthcare consumers.
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