Old-fashioned health system

Harvard professor Clayton M. Christensen feels the public health service in Norway is designed for a time when it was a good idea to have a hospital in every local community which would handle everything. – This is no longer the case, says the American. Photo: Jarl-Stian Olsen, NST.

The world-famous innovation professor has written several books on technology and management, and was a keynote speaker during this year's telemedicine conference in Tromsø. There, 250 conference participants heard his descriptions of a health service organized in a way that is much too expensive and not particularly effective.

- For each local community to have a hospital that was supposed to deal with everything was a good idea before means of communication such as aircraft and railways were developed and became available to the general public. In future, hospitals will have a much sharper focus on specialized functions, says Christensen.

Decentralize

The Harvard professor envisages a far more decentralized health service in which many tasks can be performed by staff other than specialists in hospitals, such as nurses or other health professionals. He also believes in greater distribution of tasks between hospitals to improve quality and achieve a more effective service.

Rapid service for simple diagnoses

Clayton M. Christensen describes the MinuteClinic in the USA, which offers quick service to patients with simple, everyday diagnoses such as earache, influenza, and cystitis. There, nurses are trained by doctors to handle simple diagnoses according to formal procedures.

- This gives people an accessible health service which is affordable, involves no waiting time, and relieves the pressure on family GPs and hospitals. An example of a disruptive innovation in the American health service which has been very well received by the public, notes Professor Christensen.

Understand the job

As far as the use of telemedicine in the public health service is concerned, the professor makes it clear that it is necessary to understand the job to be done.

- Telemedicine must not try to outcompete the established solution. The technology must be introduced alongside existing systems. After a while, the new technology (telemedicine) will be able to take over from established technology when people can see that it does the job just as well as "the old system," he says.

Start small

Clayton Christensen's theory of disruptive innovation indicates that pioneering changes rarely come from the large, established players, but start in areas that at the outset seem to be insignificant. But as the functionality improves and the solution is often simpler and meets the needs of groups other than traditional customers, it gradually takes over the established market.