Thursday, March 12, 2009

Disruptive Innovators at Healthcare Renewal: Disruptive to whom, exactly?

The fascinating site "HealthMemes: Tracking Conversations About the Future of Health" at http://in3.org/health/ identifies latest trends in health care disruptive innovations (innovations that go "outside the box").

I recently found out they've been linking my own writing as per a review of their archives. A number of the posts they link to over the past year or two have been mine or that of Dr. Roy Poses of Brown here at Healthcare Renewal blog, along with writings from approximately 100 other sources. The first "Permalink: attention should be paid to these posts" in the middle column of their homepage is mine, about endemic "overconfidence" in computing. My writings have also been noted at ZDNet Health by business journalist Dana Blankenhorn.

I ponder the use of the term "disruptive innovation."

Perhaps it's itself disruptive to ask the question: "to whom is such innovation 'disruptive', and for what reasons?"

From thefreedictionary.com:

disruptive - characterized by unrest or disorder or insubordination; "effects of the struggle will be violent and disruptive"; "riotous times"; "these troubled areas"; "the tumultuous years of his administration"; "a turbulent and unruly childhood"
Synonyms: tumultuous, turbulent, riotous, troubled
Antonyms (from thesaurus.com):
calming, disciplined, settling, soothing, well-behaved

On the topic of to whom ideas and writings such as mine and other HC Renewal contributors are "disruptive":

If there are disruptive innovators, then there must be a whole taxonomy of people who are not disruptive innovators.

The taxonomy might go something like this:

  • disruptive innovator
  • soothing, tradition-bound innovator
  • disruptive imitator (the antonym of innovator)
  • tradition-bound imitator
  • disruptive non-contributor
  • tradition-bound non-contributor
  • disruptive demolisher
  • tradition-bound demolisher (perhaps an oxymoron)

Disruptive innovators, thus, are disruptive to the interests of a wide variety of others.


The problems with tradition-bound innovators is that they tend not to break with politically correct custom and tradition to speak up when their innovations are misappropriated or misused. The mainstream healthcare IT community largely fits that criterion, resulting in what Harvard professors Jerome Groopman and Pamela Hartzband in today's Wall Street Journal called "Obama's $80 Billion Exaggeration" regarding an industry, HIT, hijacked from the pioneers and morphed into a runaway wagon train to a gold rush that considers clinicians the enemy of profit.

Incidentally, the points made by Groopman and Hartzband parallel the points I've been making about HIT since 1998 and that other disruptive innovators in Medical Informatics were making long before that. It's good to see an entire half page on these issues in a mainstream news source, finally.


Disruptive imitators and tradition-bound imitators propagate the good ideas of innovators, often taking credit themselves. I've worked with several CIO's and professors who fit the former category precisely.

I believe many in our medical leadership fall into the tradition-bound innovator and imitator categories, thus allowing their bondage to tradition to faciliate what has been described on Healthcare Renewal as the Anechoic Effect regarding healthcare malfeasance and other abuses.

Disruptive non contributors simply make trouble, and tradition-bound non contributors are those the Little Red Hen had to deal with.

Then there are the disruptive demolishers. These are the people with net-negative value to an endeavor or workgroup, who are only good at destroying the work of innovators of both stripes. Their demolition often serves their own (sociopathic) interests. Corporate empire builders who have often risen above their level of competence, dishonest speculators, and other parasitic character types fit into this class.

Finally, it is clear our current society whose economic system and industries have been brought to their knees, could benefit from paying significant attention to true disruptive innovators. Corporate CEO's, are you paying attention?

The disruptive demolition men and women who've led us to this point, while tradition bound others sat back and did little, need some competition.

-- SS

Addendum: it occurs to me after reading Ignacio Valdes' post "On Medieval Barbering, Wal-Mart and One Size Fits All With Health IT" at Open Source Health IT proponent LinuxMedNews.com that Open Source Software is a "disruptive innovation" and its authors "
disruptive innovators."