E-Medicine - Overcoming the NIH Syndrome

No, NIH doesn’t stand for National Institutes of Health. It stands for Not Invented Here. The NIH syndrome is often the biggest obstacle to innovation. Organizations suffer from hubris. The Not Invented Here syndrome sometimes occurs because of unwillingness to adapt an idea or product because it originates from another culture.

Proud executives believe if they didn’t invent it, it doesn’t exist or isn’t important. This attitude won’t work in the fast moving Internet world. You must outsource and use other people’s skills to grow and prosper. Thomas Friedman, in his famous book, The World is Flat: A Brief History of the Twenty-First Century (Farrar, Straus and Giroux, 2006), now on the New York Times best seller list for over 100 straight weeks, says the best way to innovate, grow, and join the 21st Century is to outsource over the Internet. To outsource, Friedman says you have to understand the Triple Convergence.

The Triple Convergence

1. The creation of a global, web-enabled playing field that allows multiple forms of collaboration, sharing of knowledge and work, without regard to distance or geography, and even language.
2. Employees now work in a vast, global pool of specialists, assembled (and disassembled) according to needs.
3. New opportunities for individuals to compete against anyone, anywhere in the world using the new, "flat" rules.

Seven New Rules for Innovation

Here are Friedman’s rules for innovation in the Internet era.

Rule #1: When the world goes flat -- and you are feeling flattened, reach for the shovel and dig within yourself. Don’t try to build walls.

Rule #2: And the small shall act big…One way small companies flourish in the flat world is by learning to act really big. And the key in being small and acting big is being quick to take advantage of all the new tools for collaboration to reach farther, faster, wider, and deeper.

Rule #3: And the big shall act big ...One way that big companies learn to flourish in the flat world is by learning how to act really small by enabling their customers to act really big.

Rule #4: The best companies are the best collaborators. In the flat world, more and more business will be done through collaborations within and between companies –whether in technology, marketing, biomedicine, or manufacturing – are becoming so complex that no single firm or department is going to be able to master them alone.

Rule #5: In the flat world, the best companies stay healthy by getting regular chest x-rays and then selling the results to clients.

Rule #6 : The best companies outsource to win, not to shrink. They outsource to innovate faster and ore cheaply in order to grow large, gain market share and more cheaply in order to grow larger, gain, market share, and hire more and different specialist – not to save money by firing many people.

Rule #7: Outsourcing isn’t just for Benedict Arnolds. It’s also for idealists.

What Does This have to do with Health Care?

It has everything to do with it. It has to do with institutional and national chauvinism, mindsets, altitudes, and attitudes. It has to do with big health systems thinking they can do everything without outsourcing patient education, preventive programs, chronic disease care, consumer-data mining, research, web-based marketing and outreach, and other functions that can only be improved through information technologies. It has to do with emboldened, informed consumers who know enough to challenge doctors and treatment protocols and to choose hospitals and providers based on quality ratings. It has to with the fact that foreign-born or trained doctors make up 25% of the physician workforce in the United States. It has to do with 150,000 Americans who, after doing their homework over the Web, sought treatment abroad last year, much administered by doctors trained here in facilities approved the foreign arm of the Joint Commission. It has to do with a wired medical world where distance, institutional walls, and national boundaries are irrelevant.