颠覆性创新(分析框架和背景研究).ppt

颠覆性创新颠覆性创新(分析框架分析框架和背景研究和背景研究)OUTLINEThe Innovators Prescription(Clayton Christensen et al,2009)Literature review on disruptive or game changing innovationsIllustrative examples from the past or presentCHRISTENSENS“TECHNOLOGY”“Technology”in Christensen et al(2009)is defined broadly,including not just machines or devices but methodology,scientific knowledge and anything else affecting the way production is carried outTechnological(or methodological)enablers allow problems to be addressed on smaller scale,with lower costs,and with less human skill than was historically needed ELEMENTS OF DISRUPTIVE INNOVATIONChristensen et al(2009)p.xx It is not just the magnitude of the advance If it works to sustain the existing business model,it is not disruptive A change in business model from the existing one to a new one which is more efficient and/or better addresses the demands of consumers is the key WHAT MAKES AN INNOVATION DISRUPTIVE?TYPE OF MEDICAL CARE-CONTINUUMPrecision medicine is the ability to precisely diagnose the cause of a patients condition rather than just the physical symptoms.It allows for standardized therapy that is predictably effective.Empirical medicine is where data is amassed to show that certain ways of treating patients are,on average,better than othersIntuitive medicine is where highly trained and expensive professionals diagnose and treat medical problems through intuitive experimentation and pattern recognitionTYPE OF MEDICAL CARE-CONTINUUMAdapted from Figure 2.4 Current Map of Common ConditionsAdapted from Christensen et al(2009)p.63 TYPE OF MEDICAL CARE-CONTINUUM“If regulators,policy makers and executives do not seek business model innovation for diseases that move toward the upper right region in this chart,the potential returns,in terms of reduced cost and improved accessibility,for societys massive investments in science and technology,will be small.”(Christensen et al,2009,p.64)TYPES OF BUSINESS MODELSolution shops are structured to diagnose and solve unstructured problems using highly trained experts.E.g.,diagnostic work in general hospitals.Value added processes generally take incomplete inputs transforming them into complete outputs of greater value.These procedures are possible after a definitive diagnosis has been made.E.g.,laser eye surgery.Facilitated networks are enterprises where people exchange things with one another.E.g.,web-sites to connect people living with a chronic disease.LITERATURE REVIEWPublished and gray literatureTime range from 2001 2011Disruptive innovation in health care(even if that was not the specific terminology used by the authors)Excluded technological or clinical innovations that did not have implications for the organization of health services(i.e.,the business model)TYPE OF ARTICLEConceptual articles that attempted to extend,modify,supplement,replace or critique the Christensen analytical framework 20%Articles that described specific innovation(s)that were disruptive or likely to be disruptive 60%Articles with general commentary or advice re:disruptive innovation 40%WHAT IS DISRUPTEDHospital care 25%Physician outpatient care 50%Pharmaceuticals 7%Medical/nursing education 5%CLINICAL ACTIVITY PRIMARILY AFFECTEDDiagnosis 15%Treatment 25%Prevention 1%System integration 15%AREAS FREQUENTLY MENTIONEDHospital care and surgeryPrimary careDiagnostic imagingPersonalized medicine(genomics)Information/communications technologyEXAMPLE:RETAIL CLINICSMay be located at a mall,a drug store or retail store and are generally staffed by nurse practitioners.Take patients as walk-ins and offer to treat a specific list of common ailments.Disrupt one aspect of primary care physician practice:straightforward diagnosis and treatment of disordersNear precision medicine end of spectrumValue-added process model using rules-based diagnosis and treatmentEXAMPLE:LASER EYE SURGERYDisrupts hospital-based surgery requiring high degree of expertiseMove from solution shop model in general hospital to value-added process model in an outpatient eye surgery centreMedical equipment innovation as enabler requiring less surgical skill than procedures it replacedEXAMPLE:REMOTE PATIENT MANAGEMENTEnabling technology:physiologic monitoring and telecommunicationsShift from hospital or home care to self care and/or care by non-clinical providersSavings from reduced ED,inpatient,skilled nursing facility useApplicable:Chronic disease,post-hospital stay recoveryELEMENTS OF DISRUPTIVE INNOVATIONChristensen et al(2009)p.xx USING THE FRAMEWORK-QUESTIONSDoes it change the position of diagnosis or treatment of disease on the continuum from intuitive medicine to precision medicine?What is the current business model for provision of the service(Solution Shop,Value Added Process or Facilitated Network)?What is the business model likely to arise after the innovation is adopted?How are the skill sets needed by providers changed by the innovation?Are changes in training needed to provide a suitable labor supply?Is the legal,social and cultural environment consistent with,and supportive of,the new business model?USING THE FRAMEWORK-QUESTIONSHow well do the existing business model and the likely new business model address specific consumer demands?Is moderately lower quality and much lower cost an attractive option?Is the new business model likely to be introduced within existing organizations or within new organizations?Are there suppliers of equipment,supporting or complementary services,needed by the new business model which do not now exist?Is the existing funding mechanism consistent with the new business model?