Saturday, May 15, 2010

Innovation - Automatic Cardiac Defibrillator and Other Examples of Disruptive Decentralization

Yesterday I wrote a blog “Limits of Innovation.” Its themes were that innovations may be good, bad, or ugly, and even good innovations don’t necessarily work in the complex world of markets and government regulations.

R. Lee Heath, inventor of pads making the automatic cardiac defibrillator , immediately and gently set my mind straight with this comment,

I find this commentary very interesting. I just want to add something more on a positive note. I would add just one quote to this. "Show me a man who is content and I will show you a failure.", Thomas Edison.”

“I think it is best to approach innovation with at least the idea that anything is possible, if you put your mind to it. Things can be made simpler rather than complicated. Certainly politics can make everything a lot more complicated. “

Roger Heath
inventor making possible the modern automatic heart defibrillator

Needless to say, I was a little shame-faced. Roger is right. We should never be content with the status quo. We should strive to make the world better. And Roger has done that. His information on Google reads,

“Roger Lee Heath, invented the electrode pads (placed on the chest of cardiac arrest victims) making possible the modern automatic external defibrillator (AED).”

“He is the only individual to invent and patent, through multiple U.S. and foreign patents, the first standardized electrical interface for the human body. His invention is now in use by paramedics, hospitals, helicopter transport operations, critical coronary care units, cardiac catherization labs, even in the home, and aboard America’s space shuttle.”

“In 1995, he was recommended by American Heart Association officials, and other peers, for the Lemelson MIT Prize, the highest prize awarded inventors, and credited with making possible the modern AED (Automatic External Defibrillator) and related intermediate first responder programs.

Heath's invention is a superb example of innovations and inventions designed for disruptive decentralization, whereby less sophisticated, even untrained people at the scene of an event – a cardiac arrest, an illness at home, an encounter in a physician’s office – can do what needs to be done, freely, at less cost, and effectively.

Other examples of disruptive inventions at decentralized locations immediately spring to mind.

• The grand daddy of them all, the personal computer and its offspring, Google.

• The portable hand-held ultrasound, with which physicians in their offices can determine if an abdominal mass or abdominal aneurysm exists.

• The portable Shape-HF cardiac-pulmonary testing device, which allows a physician in his office or a trained medical technician in any location to evaluate the cause of shortness of breath and the odds of hospitalization or sudden death.

• Audio-visual devices developed by American Telecare, Inc., at bedsides of home-ridden patients with chronic disease, which permit them to spot complications on their own and to communicate with doctors and nurses in remove locations, in the process dramatically reducing the need for hospital or ER admissions.

• Worksite clinics and retail clinics, wherein the power of proximity is at work, viz, patients can see convenient care near where they work and live for non-urgent problems.

. Practice Fusion, Inc, a "free" EMR for physicians that can be up and running in five minutes and is free to physicians because of its ad-based revenue model and its off-loading to the Internet.

. Instant Medical History, Inc, which allows patients to record their chief complaint, medical, social, and family history over the Internet before visiting the doctor and appearing in the exam room.


I like to think of these various examples as “chunking,” a term introduced in a 1998 book Edgeware. Edgeware’s authors define chunking as “Growing complex systems by allowing complex systems to emerge out of the links among simple systems that work well and are capable of operating independently.”

In other words, the long journey towards an effective health system begins with small steps. As the mother said to her small son when she sent him out on a windy day, “Big wind. Take small steps. "


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