The Innovator's Prescription: A Disruptive Solution for Health Care (Hardcover)

by Clayton M. Christensen (Author), Jerome H. Grossman M.D. (Author), Jason Hwang M.D. (Author)
Key Phrases: hospital business model, integrated capitation, intuitive medicine, United States, Harvard Business School Press, New York (more...)

Editorial Reviews

Product Description

A groundbreaking prescription for health care reform--from a legendary leader in innovation . . .

Our health care system is in critical condition. Each year, fewer Americans can afford it, fewer businesses can provide it, and fewer government programs can promise it for future generations.

We need a cure, and we need it now.

Harvard Business School’s Clayton M. Christensen—whose bestselling The Innovator’s Dilemma revolutionized the business world—presents The Innovator’s Prescription, a comprehensive analysis of the strategies that will improve health care and make it affordable.

Christensen applies the principles of disruptive innovation to the broken health care system with two pioneers in the field—Dr. Jerome Grossman and Dr. Jason Hwang. Together, they examine a range of symptoms and offer proven solutions.

YOU’LL DISCOVER HOW

• “Precision medicine” reduces costs and makes good on the promise of personalized care
• Disruptive business models improve quality, accessibility, and affordability by changing the way hospitals and doctors work
• Patient networks enable better treatment of chronic diseases
• Employers can change the roles they play in health care to compete effectively in the era of globalization
• Insurance and regulatory reforms stimulate disruption in health care

From the Back Cover

MEET THE CURE TO AMERICA'S HEALTH CARE ILLS

"Clayton Christensen has done it again, writing yet another book full of valuable insights. The Innovator's Prescription might just mark the beginning of a new era in health care."
Michael Bloomberg, Mayor, New York City

"Clear, entertaining, and provocative, The Innovator's Prescription should be read by anyone who cares about improving the health and health care of all."
Dr. Risa Lavizzo-Mourey, President and CEO, Robert Wood Johnson Foundation

"Comprehensive in its vision, astute in its diagnosis, and clear in its guidance, The Innovator's Prescription offers strong medicine for a health care system that is far from well."
Dr. Harvey V. Fineberg, President, Institute of Medicine

"A wealth of insights--with new ideas and revelations in every chapter. Read it, and you will be armed with solid ideas for making health care better."
George Halvorson, Chairman and CEO, Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Hospitals

"The Innovator’s Prescription is a well researched, clearly organized road map to a sustainable health care system."
Michael O. Leavitt, Secretary of Health and Human Services

"The Innovator's Prescription is an important and timely contribution to the national debate on health system reform. We would do well to consider it carefully."
Tom Daschle, former Senate Majority Leader and Distinguished Senior Fellow, Center for American Progress

"Clayton Christensen has helped many businesses—including our own--find new growth opportunities through deeper insights into the future of health and the health care system. I can think of no one better equipped to lead this comprehensive global assessment."
Bill Weldon, Chairman and CEO, Johnson & Johnson

Clayton M. Christensen's bestselling books are:

"REQUIRED READING."BusinessWeek

"ABSORBING."The New York Times

"THOUGHTFUL."Fortune

"BRILLIANT."Michael R. Bloomberg

"VISIONARY."Publishers Weekly

See all Editorial Reviews

Product Details

• Hardcover: 496 pages
• Publisher: McGraw-Hill; 1 edition (December 4, 2008)
• Language: English
• ISBN-10: 0071592083
• ISBN-13: 978-0071592086
• Product Dimensions: 9.1 x 6.1 x 1.7 inches
• Shipping Weight: 1.8 pounds (View shipping rates and policies)
• Average Customer Review: 4.9 out of 5 stars See all reviews (22 customer reviews)
• Amazon.com Sales Rank: #1,215 in Books (See Bestsellers in Books)

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Customer Reviews

Most Helpful Customer Reviews

13 of 13 people found the following review helpful:

4.0 out of 5 stars What rather than who, February 18, 2009

By	William Whipple III (Middletown, Delaware) - See all my reviews (REAL NAME)

It is a commonplace that the U.S. healthcare system is broken, but the discussion often degenerates into a debate about who is responsible. This book takes a different approach, focusing on what is wrong with the healthcare system and needs to change so it can work better.

The proposed solution is to discard the current fee for healthcare service model, in which healthcare providers are systematically paid to treat illness without recompense for fostering welfare, and create a three-track system:

(1) Fee for service would continue to apply to diagnostic services, where - due to the nature of the patient's condition and the state of medical knowledge - there is a high need for intuitive investigation versus results-based treatment for conditions that are well understood. (The process described brings to mind episodes of House, a TV show in which a brilliant but irascible doctor challenges a team of colleagues to find the problem before the patient dies.)

(2) Fee for result would apply for treating conditions that are well understood and have a clearly defined solution -- colonoscopies, laser eye surgery, implantation of stents, etc.

(3) User networks for patients with chronic conditions/ unhealthy practices to learn how they can help themselves and be motivated to do so.

As is pointed out again and again, disruptive changes will be needed to get from A to B. Thus, hospitals must be redirected to focus on diagnostic services and cede provision of standardized care and wellness coordination to specialized clinics and other agencies. Primary care physicians (the traditional "family doctor") should concentrate on diagnostic services at a lower level rather than acting as "gatekeepers" for referrals to specialists. Enabling changes in reimbursement rules, health insurance arrangements, and medical record keeping are spelled out in detail.

When the dust settles, there will be fewer hospitals (with the survivors focused on enhanced diagnosis, like the Mayo Clinic), fewer medical specialists (who currently operate in narrow niches, often without a full grasp of a patient's situation), more primary care physicians and nurses with augmented responsibilities, a new model for pharmaceutical companies that focuses on targeted medications for precisely defined conditions versus the development and marketing of "blockbuster" drugs that only help a fraction of the users and require enormously expensive mass clinical trials, and a lot of medical work performed by less highly trained personnel with better diagnostic tools.

Andy Kessler presented an analogous vision in "The End of Medicine: How Silicon Valley (and Naked Mice) Will Reboot Your Doctor," Harper Collins (2006). His book is very entertaining, but this one covers the ground in a more disciplined and comprehensive manner. I would recommend "The Innovator's Prescription" for anyone who is seriously concerned about the current healthcare system.

Doctors, hospitals, and other healthcare providers cannot make the needed changes on their own, because they do not control all the levers. Having the government take the lead is said to be problematic, for reasons that are dispassionately stated and I happen to agree with. The authors suggest that the best candidate entities for leading the transition to healthcare in the new mode might be employers that profit from the good health of their employees. Then there is the intriguing possibility of expanding the role of integrated healthcare providers,e.g., Kaiser Permanente.

Let's hope our country chooses the right path.

8 of 8 people found the following review helpful:

5.0 out of 5 stars A brilliant analysis -- if only Washington would listen, March 25, 2009

By	Joshua D. Bernoff "Co-author of Groundswell -... (Arlington, MA USA) - See all my reviews (REAL NAME)

Clayton Christensen, the groundbreaking thinker behind "The Innovator's Dilemma" turns his mind to the healthcare industry. If you know The Innovator's Dilemma you know that the focus is on disruptive innovation -- specifically on how little, initially imperfect technological solutions (think PCs) can disrupt big, rigid, expensive businesses (think mainframes).

Is there any bigger, more rigid, more expensive business than healthcare?

This exhaustive and extremely well researched analysis (done together with two doctors, the late Jerome Grossman and Jason Hwang) describes in a way that was clear to me for the first time, what's wrong with the health care industry. Basically, it's designed to pay for the wrong things.

The Innovator's Prescription shows how health care businesses are of three types: "solution shops" that use clever people to solve problems, value-adding process businesses that do the same thing well over and over, and facilitated networks (like Alcoholics Anonymous). Because elements of the health care system (like hospitals) do all of these, they can't get good at any one, and they can't shift costs effectively. And the system, as it always does, reject changes that would allow healthcare to be more efficient.

Let's be fair: this book is too long, partly because the health care system is too complex and the authors take on every single problem. But they have a proposed solution to all those problems. I wish the Obama administration would get a good look at this analysis, since it's not overtly liberal or conservative -- instead, it's the only way we could actually get past the cost and quality problems in the health system.

If you've ever sat in a doctor's waiting room wondering "why is this system such a mess -- isn't there any way to make it better," this book is for you. Read it. Then tell your congressman to read it.

14 of 16 people found the following review helpful:

5.0 out of 5 stars An Industry Insider's Review of Christensen's Prescription for a Cure, February 2, 2009

By	Thomas M. Loarie (Danville, CA USA) - See all my reviews (TOP 1000 REVIEWER)    (REAL NAME)

I have been an active participant in healthcare developing and commercializing over twenty medical technologies across nine medical specialties since the 1970's. I have also lectured on the medical industry as an Assistant Professor of Surgery at Creighton University Medical Center and as a guest lecturer at Anderson School of Management (UCLA), Haas School of Business (University of California), and Graziadio Business School (Pepperdine University), and spent significant time in the 1990's on FDA reform.

I have been privileged to have had a front-row seat observing the major changes that have shaped today's healthcare system - industry consolidation for both the supplier (pharma, med-tech, and diagnostic) and delivery (hospital, clinics, physician practice) segments; the move from unregulated fee-for-service to regulated fee-for-service; the growth of medical malpractice and its impact on the cost of healthcare; the use and misuse of technology; the draconian regulatory burden (FDA and CMS) associated with developing new life-improving or life-saving technologies; and, as a result, the growth of healthcare as a share of GDP from 6% to 16%. To this industry insider, healthcare is a system in critical condition and needs radical surgery.

Clayton Christensen who authored one of the best books on innovation ("The Innovator's Dilemma") has now teamed up with Jerome Grossman, M.D. and Jason Hwang, M.D. to bring well-researched insights into a disruptive solution for effective value-added health care in "The Innovator's Prescription." Christensen and company outline the technological enablers of disruption then show us how various aspects of the healthcare system can be effectively disrupted to produce better, more cost-effective healthcare for all Americans. These include the hospital business model, the physician practice business model, the care of chronic disease, the reimbursement system, medical education, the development of pharmaceuticals, medical devices, and diagnostics and regulatory reform. The authors leave no stone unturned and provide an integrated plan to make it happen.

"Innovator's Prescription" is a must read for all who participate directly in the funding and running of our healthcare system whether as members of the private sector or public sector, patients, or voters. Christensen and colleagues have done an extraordinary job in outlining the fundamental issues but more importantly, in providing a thoughtful way out of our current mess.