“The department of redundancy department.” I first heard that phrase while in journalism school. I’m pretty sure one of my professors had written it on an assignment of mine to call attention to the fact that I had crossed the line between proving a point and belaboring one.
At the time, I thought it was a cute way to tell me to stop repeating myself. But during the past four years, as I’ve heard the words health care reform again and again, I’ve started to think the department of redundancy department wasn’t just a joke. Maybe it actually exists and is working behind the scenes to try to change our health care system by doing the same old thing time and time again.
Probably the most notorious part of the recent attempt at health care reform (which itself is nothing new, Hillary Clinton took a stab at it in 1993) was the health insurance mandate. People became fixated on it. It was trampling our constitutional rights. The government was telling us what to do. It would just line the pockets of insurance companies. But no one seemed to stop and question if it, or any part of health care reform, was going to truly change and improve our system. Wouldn’t there still be huge deductibles, co-pays that were too high and plans with 80/20 coverage that would still leave an average person with medical bill debt? And how would we keep health care costs down while increasing access to care?
To truly change the health care system, disruptive innovation is needed. I first heard the term disruptive innovation while attending an Illinois Organization of Nurse Leaders conference in 2009. Jason Hwang , MD, MBA, Executive Director of Healthcare at Innosight Institute, gave a speech on how disruptive innovation could be applied to our health care delivery system to create change.
Just what is disruptive innovation? A theory developed by Harvard Business School Associate Professor Clayton M. Christensen, disruptive innovation:
- Meets the needs of new customers overlooked by existing products or services in the marketplace
- Slowly improves the performance of the product or service to which it has been applied
- Has a value that becomes appreciated by the mainstream market
- Because of its improved perception, replaces and disrupts the existing products and services in the market.
One simple example of disruptive innovation is Toyota. When it entered the U.S. marketplace, Toyotas were cheap but not the most reliable vehicles. Still, people who couldn’t afford cars before were able to buy Toyotas. The company began to refine and improve the quality of its cars, and eventually, Toyota earned a reputation of having cars that were more economical and better quality than American-made autos.
In health care, retail clinics, telemedicine and mobile personal health records all have the potential to cause disruption in the health care delivery system. One innovation I think has huge potential to change health care delivery is the Hospital at Home care model developed by the Johns Hopkins Schools of Medicine and Public Health.
Patients who need hospital-level care, but are at a low risk of clinical deterioration and who are less likely to require highly technical hospital-based procedures, can be admitted to Hospital at Home if they meet medical eligibility criteria. Patients with illnesses like heart failure, chronic obstructive pulmonary disease, cellulitis or urinary tract infections are good candidates for Hospital at Home. This care model has been found to lower costs by nearly one-third and to reduce complications.
Technology often helps drive disruptive innovations. There is no doubt in my mind that HIT could help shift the way we deliver health care. Perhaps it could improve nurse triage lines, prevent readmissions or allow specialists to perform virtual visits with patients who are not in their geographic area. The possibilities are endless. How do you think HIT can disrupt our health care system and provide lower-cost, higher-quality care?