Innovation distinguishes between a leader and a follower.

The late Steve Jobs once said "Innovation distinguishes between a leader and a follower[1]." And “The computer industry shifted from mainframe to personal computer, next from personal computer to interpersonal computer.

I actually think as we all can see that we’ll now go from interpersonal computer to internet of everything. Let’s face it, this month 20 years ago Windows 95 was introduced, and the iPad is only 5 years of age. Your grandchildren will grow up in a world that never lacked a connection and they will laugh when you share your stories about having to charge your phone every day. The speed of change is accelerating at an (almost) exponential scale.

And still, the way we basically deliver healthcare hasn’t changed much for over a hundred years. Although we all clearly see the change in society around us, we tend to think technology and societal change, or “what you’re doing is so complicated that it can’t be done differently” will not really affect “your” job or profession.

Einstein said “If you always do what you always did, you will always get what you always got.”

[The why, or the need to innovate]
For the last year we partnered with Philips and Salesforce [2]to find new pathways to better health(care). New technology brings new options to the table, which could solve issues we’ve had for ages. At this very moment we have just announced our latest endeavour of a prototype to give people with type 1 diabetes (at first) the option to combine features of a lot of siloed systems out there, into one solution supported by an app. Together with patients (#patientsincluded) we’ve crafted a path for a less interrupted life, that we next will turn into a trial and ultimately into a highway.

We are realists and we don’t know for sure if this really is going to work the way we envision, but that is exactly the point here. Working with these global giants -Philips and Salesforce- brings in technology and knowledge that, combined with our academic and clinical expertise and our #patientsincluded approach, makes rapid iterations possible and along the way create a truly scalable solution.

If we stop wanting to improve and innovate with new models in healthcare, we actually would stop wanting to make patients better. Innovations in the medical field will drive the race to - in the end - make the chances of dying at any given age less and less.

In the field of medical technology and pharma there has always been a fair amount of innovation – development of new products. However on issues of how we deliver health(care), things have been static for a long time. There would probably never be a reason to innovate anymore, until something comes along that brings a new service or experience, procedure or device to the healthcare market – something as new as, for instance, Uber.

If we look at the spectrum of medical grade devices at one end and low-cost consumerlevel at the other end, we will see the emergence of the pro-sumer device: validated, low-cost devices that will hit the market, giving consumers access to devices with features that in the past were only available to professionals.

And that is exactly what is happening right now. Most probably players that did not exist in health(care) will come out with great innovations, companies like Theranos or Scanadu. In the current Fortune 50 there are 24 companies that did not exist 5 years ago, and I expect the same will happen in health(care). In 10 years from now the deck will be reshuffled intensively, with only organizations that “live innovation” in the top of that list.

Yet some 100+ year old companies, like Philips, seem to embrace these new waves of innovation, restructuring their company and their product range as in their recent announcement of their Personal Health Services portfolio

Fact of the matter is that society simply will not have the resources to treat the number of people who will need healthcare; we’ll fall short in both in terms of professionals and financial resources. In contrast to today’s linear innovation process, driven by functional experts in a specific technology, we have to move to a more systemic process driven by cross-functional facilitators that can never stop and always will find innovative ways to improve.

[The how and what kind of innovation]
We often define innovation in healthcare in three kinds; Consumers, Technology and Business Models. (HBR 2003, Herzlinger[3])

Translated for health(care) i think this is what it looks like:

• The consumer perspective will change from quality care at a fair price to that plus ease of use. The latter will be the real change in healthcare – huge improvement in the burden of how to “use” healthcare. People expect their healthcare experience to be as smooth buying flights or everyday errands, and online will have to be a big chunk of that.
• On the technology perspective we will see that the challenge of the absence of a connection between all the islands of information keeps the current fragmentation alive, hindering what people really need for their health, but it will vaporize due to system integration and data. These most probably will be made by companies from outside of healthcare, that already have transformed other businesses, most likely from a data perspective. They will also democratise healthcare by creating transparency of costs and outcomes by connecting the dots to decrease costs and improve outcomes. The patient ‘owning’ his own data should be as normal as ‘owning’ his own banking data. As healthcare will innovate through better information, it will become more of a software business.
• apart from the impact of a business model healthcare players will build ‘solution shops’ based on deep expertise due to the delocalisation of healthcare and the highly personalised option based on personal data. It will bring other players with new (business) models with same or even better outcomes, that will be reimbursed by the payers. This will be true especially on the preventative side, with the help of all kinds of new devices and data solutions. Also we will move more and more from fee for service to pay for outcome. (See Accountable Care Organizations).

 All of these will be impacted on top of that by the ongoing globalization that’s coming to the biggest market in the world: Health(care). As at one point in time, every one of us will become a patient and start using healthcare. It pays off to act on a global scale, also for all of us in terms of effective use of resources, making solutions available on a worldwide scale as opposed to only ‘locally’!

As Radboudumc (Radboud University Medical Center in Nijmegen, the Netherlands) we have come a long, long way; our history -with a turning point when the health inspectorate closed down one of our wards some 10 years ago[4]- also defined our destiny to innovate. There was a clear need for change, and the ambition to improve was present. Next came room to discuss and debate the way the hospital was run. Over time Radboudumc turned into a place to be heard, and there was room to experiment, to innovate and created the REshape Center[5] (an innovation cell at the convergence of patient empowerment and technology). We (re)discovered the patients, started listening and talking with them and made them our partner. Jointly we found the real needs of patients, and started to redesign our way of work. Bold choices were made, for example in the frontier of IT and also in terms of transparency. We want to have an impact on people’s lives.

[closing]
We really think Academic Medical Centers should take the lead in this. Together with their network and patients we really could move mountains.

You know what they say about sports: it’s easier to get to the top than to stay there. So others will follow, and others are following.

Change is the new constant in every step we make, discussing over and over again the way we do things, makes us aware of opportunities to improve. To see if there is a better way to do the things we do, and if technology as a tool (not a goal in itself) can help us. The question should be how to make ourselves obsolete. No one has to fear for a job by this: if we keep playing ‘Champions League’ Innovation. There is NO way we will be able to cope with the growth in demand as we face it.

If we keep leading in innovation, then we will be the ones that together with entrepreneurs and people from other industries will find new ways. But If we wait to follow, then we have chosen to stop becoming better tomorrow. We will always be behind in what we offer our patients.

We will not know everything that will cross our path, and we might have to do things we’ve never done before. Einstein said : “It’s called ‘research’ because we don’t know what we are doing,” We have to innovate our way into a sustainable future in all three pillars: consumer, technology, and business model.

Innovating ourselves away from siloed and fragmented healthcare (information), together with all stakeholders (#patientsincluded) at the table, to find new delivery models that embrace new technology, creates the chance to set stage for a sustainable future for health(care).

So the question is: If ‘innovation distinguishes between a leader and a follower’, where do you want to be?

[1] https://www.mhprofessional.com/product.php?isbn=007174875X
[2] https://www.dhirubhai.net/pulse/20141013143013-19886490-changing-the-life-of-patients-together
[3] https://hbr.org/2006/05/why-innovation-in-health-care-is-so-hard
[4] https://www.bmj.com/content/349/bmj.g5765 interview with Melvin Samsom, then Chairman of the Board
[5] https://radboudreshapecenter.com/about/