March 20, 2009

Shakeup needed to reform health system: speaker

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Author Clayton Christensen, M.B.A., talks about changes that could improve health care delivery. (photo by Joe Howell)

Shakeup needed to reform health system: speaker

Clayton Christensen, M.B.A., the Harvard Business School professor and author who coined the term “disruptive innovation,” spoke at the Vanderbilt University School of Nursing Centennial Lecture Series last week, providing his insight on what it will take to transform health care.

Christensen defines disruptive innovation as a technology, process or business model that markets a significantly more affordable product or service that is also much simpler to use. It enables more consumers to use the product and results in the innovation replacing, or disrupting, the status quo.

“Almost every industry has gone through this cycle,” said Christensen. Using computers as an example, he discussed how centralized, sophisticated mainframe computers were disrupted by de-centralized mini-computers that ultimately resulted in the easy-to-use and relatively affordable laptops of today. Based on research from hundreds of different companies, Christensen cited examples of disruptive innovations that challenged established industries with less expensive, more user-friendly technology.

In the health care arena, disruptive innovations include advances in diagnostic imaging, ambulatory care and the roles of many different health care providers.

Christensen believes traditional large hospitals are no longer viable business models. He believes it made sense to centralize care due to the complexity and expense of technology such as imaging equipment and surgical suites. “In other words, hospitals focused on bringing the problems to the solution,” he said.

Instead, he encourages hospitals to move toward a model of “solution shops,” which reduce overhead and provide more integrated care for major categories of disease.

“What has to happen to make health care affordable and accessible is that we need to take the simplest of the problems handled at the general hospital and bring that technology to ambulatory centers,” said Christensen. “Then, we need to bring technology to the doctors' offices so they can do the things that previously had to be referred to the ambulatory clinic.”

He went on to say that greater technology in the general practitioner's office will reduce the need for referrals to specialists. Nurse practitioners and physician assistants will take on more responsibilities from physicians, and even patients and family members will take on more responsibilities.

“By enabling lower-cost venues of care and lower-cost caregivers to become progressively more capable — that's the mechanism by which health care becomes affordable and accessible,” said Christensen. “Nursing as a profession, and nurse practitioners in particular, play a key role in bringing a solution to where the problems are.”

The VUSN Centennial Lecture series will take place throughout the academic year. The next speaker is U.S. Rep. Jim Cooper, who will speak on Tuesday, April 7 at 4:15 p.m. at the School of Nursing. More information is available at