Innovator’s Prescription

“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”.

So says the Harvard Business School’s Clayton M. Christensen, whose bestselling The Innovator’s Dilemma revolutionized the business world.

Christensen is correct. In the United States, Health Care is a 2.5 trillion dollar industry accounting for 17% of Gross Domestic Product.

Innovator’s Prescription, is a must read for those of us who work for or with health care providers and anyone else interested in learning more about health care.

The book provides historic examples of how industries other than health care were disrupted by new business models that changed the way products were made and services delivered.

Based on Christensen’s book we developed a high level Process Classification Framework (PCF) for hospitals. Like most industries, the three main processes are developing new products/services, maintaining services, and delivering services as illustrated for a hospital in the next column.

Develop New Services

Maintain Services

Service Line

Patient data

Business recurring/non recurring

Delivery Processes (pathways)


Prevention and early detection

Specialist (non coherent)

Specialists (coherent)


Rule based (precision)

Empirical based


Under the delivery process the two main items are diagnose and treatment. Sometimes diagnosing a disease or illness is as simple as a blood test. Other times it requires a single specialist or a group of specialists.

Rule based (precision) treatments are those cases where a disease can be precisely diagnosed, whose causes are understood, and can be treated with rule based therapies that are predicatively effective.

Intuitive treatment is for conditions that can be diagnosed only by their symptoms and only treated with therapies whose efficacy is uncertain.

Carlos Pulido

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