On the advice of a collegue I picked up a copy of
The Innovator's Dilemma by Clayton M. Christensen yesterday. I'm more than two thirds of the way through it and heartily recommend it to anyone involved in Healthcare IT. It includes case studies of several industries, including a couple that will be familiar to IT folks:
- Hard Disk Drives
- Microcomputers
- Discount Retailers
- Steel Mills
- Excavators
The case studies are more than just anecdotal narrative. The author puts together some very compelling evidence based on detailed research about how disruptive innovation causes well managed companies to fail. While the book was written more than 10 years ago, the advice given is still very sound. Even as the author describes events from a decade ago, I found myself identifying more recent events (the rise of solid state storage and the USB memory stick, the laptop computer, the PDA and the smart phone), which follow similar patterns.
In almost all cases of innovation that Christensen describes, the disruptive innovation starts downmarket, and eventually creaps upmarket to displace prior market leaders. The importance of this work in Healthcare IT comes from couple of sources of disruptive innovation:
- The Health Information Exchange as a platform for electronic health records.
- The emergence of lightweight EMR products and Software as a Service (SaaS).
- The interest in easier to use standards with a lower point of entry (e.g., NHIN Direct vs. NHIN CONNECT, Green CDA and CCR vs. CDA and CCD, REST vs. SOAP)
The HIE space is arguably not "downmarket" from the EHR space but it is definately a new market.
Christensen has two other books that follow up on The Innovator's Dilemma, one titled The Innovator's Solution, and a third titled The Innovator's Prescription which is specific to healthcare. Based on what I've read so far, I'll be purchasing the next two shortly.
Just put down my Innovator's Dilemma review.. It's a brilliant book, but very tough to slog through. This was one of Steve Job's favorite books and you can see his fingerprints all over it: from the Apple Stores (killing/ignoring the customer, in this case, distribution), doing the iPod at the low end then moving it upmarket, and even Steve's contempt for focus groups and asking the customer what they want. It's very smart and shows the holes in the current NYSE driven Corporate culture. To be really innovative you have to throw out all those masters. Well done Clayton for writing it and well done Steve for implementing it.
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