Schemes, Dreams, Disruptive Reforms

The best laid schemes o’ mice and men
Gang aft a-gley.

Robert Burns (1959-1796), To a Mouse (1785)

We are the music makers,
And we are the dreamers of dreams.
World-losers and world-forsakers,
On whom the pale moon gleams,
Yet we are the makers and shakers,
Of the world forever, it seems.

Arthur William O’Shaughnessey (1844-1881), Ode to Music Makers


February 5, 2012 - Today I bring your attention to an important blog – “Nimble Medicine,” in The Health Care Blog,by David Chase, CEO of Avado.com (February 5, 2012).

Chase presents images developed by Jason Hwang, M.D., MBA, executive director of Healthcare Innosight Institute in Boston.

Here, in print form, isthe new ecosystem of disruptive new business models. You might call these images as the Gospel of disruptive innovation, as conceived by Hwang and his mentor, Clayton Christensen of Harvard Business School, coiner of the term “disruptive technology.”

New Health Care Business Models

• Wellness programs

• Worksite clinics

• Telehealth/e-visits

• Mobile care services

• Hospitals at home

• Wireless health services

• Automated kiosks

• Home monitoring

• Retail clinics

• Home visits

• Services while traveling abroad

• Medicare home and care teams

New Technologies in Old Business Models, Raise Costs


But, so far, plugging new technologies into old business models has caused health costs to rise rather than fail, as manifested in:

• Increased Specialization

• More Imaging services

• More Laboratory services

• More clinical research and training

• More Data collection and wireless services

• More Regulation, licensure and accreditation, clinical resistance, payment and reimbursement policies

• More Surgical suites

Centralization, Decentralization, Then Sweeping Decentralization

These services and developments have increased costs. They are accompanied by centralization followed by decentralization. But, fortunately,Innosight predicts, decentralization is only beginning in health care, i.e., HIT innovations will sweep through the health care sector.

All of this comes under the heading of “nimble medicine” – disruptive care anywhere, anytime, all the time, guided and inspired by information technology schemes and dreams, delivered by less-sophisticated generalists, demanded by consumers, and payers, and less-specialized persons using mobile wireless devices.

Tweet: The dream of nimble, disruptive medicine with new, less costly, and decentralized business models, will come fast and overwhelmingly.