In a number of previous notes, I have suggested that our healthcare system is broken and needs radical reform. In one of them, I pointed out some of the absurdities of hospital pricing (see: Why the Prices Charged by Hospital for Inpatient Care Are Irrelevant). I have also discussed in previous notes the idea of disruptive innovation that was originated by Clayton Christensen and colleagues. Dr. Jason Hwang, a co-author with Christensen of "The Innovator's Prescription: A Disruptive Solution for Health Care" will be lecturing about this same topic at the upcoming Lab InfoTech Summit on March 16, 2009, at the Venetian Hotel in Las Vegas.
Many people are in agreement that we badly need a new healthcare business model and disruptive innovation can provide a lens through which we can better understand the changes that will be necessary. A recent article in the New York Times discusses this specific idea (see: Disruptive Innovation, Applied to Health Care). Boldface emphasis is mine:
Almost every sentence in this excerpt is juicy and food for thought. I hardly know where to start in order to react. To pick only one of the ideas, I particularly like the following: Disruptive innovators in health care aim to shape a new system that provides a continuum of care focused on each individual patient’s needs, instead of focusing on crises. I have discussed the need for a continuum of care in previous notes (see, for example: Predisposition to Disease and Pre-Disease on the Health Continuum). You may want to review the diagram presented with this note that illustrates the ideas of predisposition to disease, pre-disease and clinically overt or manifest disease.
I am in favor, as noted in the excerpt above, of having nurse practitioners initially see most patients and treat routine ailments using well-defined diagnostic and treatment algorithms. In addition, I believe that greater use should be made of the superb medical diagnostic options that are now available and getting more sophisticated by the day. These would include clinical lab testing, including molecular diagnostics, with some selected medical imaging initially. This will enable the diagnosis of pre-disease, which is to say disease in its earliest stages, and a broader orientation toward preventive medicine. The more complicated patients will be referred to physicians by the nurse practitioners for more complicated diagnostic procedures and ultimately treatment. As noted above, such a broad approach will help to avert much of the crisis-oriented care of today.