The Innovators Dilemma in Health

This years Friends of the Kings Fund lecture was by Clayton M. Christensen, author of the wonderful 'Innovators dilemma' and one the worlds top business thinkers. Clayton's thesis is that existing companies are good at listening to their customers and driving toward ever higher margin work; but that makes them ill equipped to deal with new, disruptive products in their markets.

The talk focused on  the challenges facing healthcare as we move to a more integrated world.

Clayton was incisive and insightful and we won't try and do his talk justice here. There are, however, some interesting stats that we thought would be worth sharing:

1. Every time you double the number of routes through a hospital, overhead increases by 1.3. For example, a hospital with 110 different pathways in California had a 85% overhead associated with just moving patients about.
2. By specialising you can dramatically decrease cost and improve outcomes: Shouldice Hospital, Ontario, a specialist hernia centre can do that operation for 35% of the cost, with 1/10 of the complications of a general hospital in the same area.
3. Hospitals should consider what 'job' they are doing for the patient; are they Consultative (diagnostics), or Procedural (elective surgery). These need very different layouts and organisation. One major issue is that we often try and be both.
4. Finally, we should think about the decentralisation of healthcare which will naturally occur as complex operations get deskilled by learning or technology, and how we should organise our healthcare systems best to manage this.

Clayton finished the talk with a message of hope for the NHS - he believes that as we transition to a new style of healthcare delivery, the UK, and the NHS are best suited to manage, adapt and flourish.