Innovation or Incrementalism: Why Healthcare Struggles with Technological Disruption

When I first stumbled upon the concept of disruptive innovation in healthcare some years ago, I was hooked. As a young professional passionate about improving healthcare systems, I saw disruption as the superhero cape healthcare needed. The idea—popularized by Clayton Christensen—promised, in my opinion, a transformation that would empower patients and physicians alike, stripping away inefficiencies and putting health outcomes at the center of care. It felt revolutionary, almost poetic: small, nimble innovators challenging the status quo and forcing an industry to evolve. It seems foolish now, but I remember writing about a shorter time from symptom to diagnosis, patient appointments at the tap of a finger, and simplified authorization and collections. Oh, the na?veté of dreamers. It was going to be inmnovation happily ever after.

But then, something happened. As I worked deeper in healthcare IT, I started seeing cracks in the foundation of this theory. Why weren’t these disruptive ideas taking root as Christensen had envisioned? Why did it seem like healthcare, an industry ripe for transformation, was fighting against change?

It turns out, disruption isn’t a one-size-fits-all solution, and healthcare—unlike retail, media, or even transportation—has unique complexities that make adopting technological disruption an uphill battle.

What Is Technological Disruption?

Before diving into why healthcare struggles with disruption, let’s define it. According to Clayton Christensen, Disruptive Innovation describes a process by which "a product or service takes root in simple applications at the bottom of the market—typically by being less expensive and more accessible—and then relentlessly moves upmarket," displacing established market leaders and systems. These innovations often begin as cheaper, simpler alternatives that appeal to overlooked segments of the market. Over time, they improve and encroach on mainstream markets, reshaping entire industries.

In healthcare, disruption could look like telemedicine providing care to underserved populations, AI improving diagnostic accuracy, or wearable devices shifting care management from the clinic to the home. However, while these innovations show promise, their adoption is often slow, uneven, or stymied altogether.

So, why does healthcare resist disruption?

The Challenges in Adopting Disruptive Innovation in Healthcare

1. Organizational Inertia

Healthcare systems are massive, complex, and notoriously slow to change. Many organizations operate under technological and cultural legacy systems that resist disruption. A 2021 HIMSS study found that "up to 73% of healthcare providers may still use legacy systems. These systems were designed for stability, not agility." The "if it isn’t broken, don’t fix it" mindset dominates, even as inefficiencies abound.

For example, implementing electronic health records (EHRs) was meant to streamline patient data management, yet it’s often cited as a source of burnout for clinicians. Why? Because the systems were layered onto existing workflows rather than designed to replace outdated processes. This pattern—of retrofitting innovation instead of rethinking systems—is a hallmark of organizational inertia.

2. Regulatory Barriers

Regulation in healthcare is essential; it protects patients and ensures safety. But it can also slow innovation to a crawl. Gaining FDA approval, meeting HIPAA compliance, or navigating state-specific telehealth laws can take years. Startups, often the drivers of disruption, may not have the time or resources to survive these prolonged processes.

Take AI in diagnostics as an example. Even when algorithms outperform human physicians in identifying conditions like cancer, their deployment faces hurdles like unclear liability and stringent validation requirements. These barriers, while rooted in patient safety, often delay life-saving advancements.

3. Cultural Challenges

Healthcare is deeply personal, and its culture reflects that. Physicians and administrators often prioritize reliability and predictability over experimentation. The Hippocratic Oath—"First, do no harm"—is a noble guiding principle, but it also fosters risk aversion. Disruption, by its very nature, is messy and uncertain, making it an uncomfortable fit for a culture that values control.

Additionally, patients themselves can resist disruption. Many people trust traditional healthcare models and are wary of innovations that seem unfamiliar or impersonal, like telehealth or AI-powered chatbots. Without buy-in from end users, even the best innovations can fail to gain traction.

4. Private Equity Interests

Private equity’s increasing presence in healthcare adds another layer of complexity. While these investors bring capital, their short-term focus on profitability often conflicts with the long-term nature of disruptive innovation. Private equity-backed organizations may prioritize incremental improvements—which deliver quicker ROI—over transformative change. This dynamic can stifle the very disruptions needed to improve patient outcomes and reduce costs.

Why Incrementalism Often Wins in Healthcare

Incremental improvements are safer, faster, and less expensive than disruptive overhauls. In many cases, healthcare organizations choose to improve existing systems—like optimizing EHR workflows or expanding telehealth services—rather than investing in unproven technologies that might fail. This risk-averse approach creates a cycle where innovation happens in small steps, leaving transformative disruption on the sidelines.

Incrementalism isn’t enough. It addresses symptoms rather than root causes, leaving foundational issues unresolved. For example, improving billing software doesn’t address why healthcare costs are so opaque.

How Healthcare Can Embrace Disruption

Despite these challenges, healthcare can and must become more open to disruption. Here’s how:

1. Reframe Risk as Opportunity

Healthcare leaders must shift their mindset around risk. Instead of seeing disruption as a threat, they should view it as an opportunity to solve persistent problems. This involves fostering a culture that encourages experimentation, learning from failure, and iterating quickly.

2. Streamline Regulatory Processes

Regulatory bodies must balance safety and innovation. Programs like the FDA’s Breakthrough Devices Program, which accelerates approval for promising technologies, are a step in the right direction. Expanding such initiatives could help bring disruptive innovations to market faster. Stay tuned for an upcoming post on our regulatory landscape and how it can and must be improved.

3. Collaborate Across Stakeholders

Disruption requires collaboration among startups, established healthcare organizations, regulators, and patient advocates. By working together, stakeholders can effectively address challenges like reimbursement models, interoperability, and patient education.

4. Invest in Long-Term Solutions

Private equity firms and healthcare organizations should align financial incentives with long-term outcomes. This might mean funding innovations that won’t deliver immediate returns but have the potential to transform care delivery and reduce costs in the future.

5. Educate and Empower Patients

Patient acceptance is critical for disruption. Educating patients about the benefits of innovations like telemedicine, wearables, or AI can build trust and drive adoption. Engaged patients are more likely to embrace change and advocate for better care.

The Path Forward

Reflecting on my early enthusiasm for disruption, I realize my optimism wasn’t misplaced—it was just incomplete. Disruption in healthcare is possible, but it requires more than innovative ideas. It demands a concerted effort to overcome barriers, rethink entrenched systems, and prioritize patient-centered outcomes.

The next wave of healthcare innovation will not come solely from technology. It will also come from leaders willing to challenge the status quo, organizations ready to take calculated risks, and patients empowered to demand better. Together, we can move beyond incrementalism and toward a future where technological disruption delivers on its promise to transform healthcare for the better.

I'm very interested in your thoughts about disruption in healthcare. Would Christensen be disappointed in healthcare? Leave me a comment and share this question with your network.