Incubators can be critical to sustained corporate success, but they are fiendishly difficult to get right. With a broad mandate and scant constuituency or resources, they struggle then fall victim to inevitable cost cuts. But there is quite a silver lining to the dark cloud -- when incubators do well, success can be spectacular.
In a piece for Forbes, I explore seven dimensions of incubator design through the example of one in healthcare. There is no single model for designing an incubator, but there is a set list of factors that need thinking through for success.
Click for more information and a book chapter on building corporate innovation capabilities and incubators.
Reframing markets is hard. Companies that may have succeeded with the same basic strategy for decades have a tough time re-defining where they play when their core business starts commoditizing. An even more difficult challenge is orienting the firm around that new strategy when the resources, processes, and priorities of the company are tightly linked to the old model.
For many pharmaceutical and medical device companies, a great hope for escaping intense pricing pressure is to change what they sell from drugs and implants to integrated solutions for major diseases. They reason, correctly, that the cost of pills or devices can be a small component of the overall cost of patient care, and that a holistic approach toward patient needs can create far more value -- through better medical outcomes and lower total costs -- than disconnected therapies like a prescription.
The strategy makes sense, but there is a very big problem. The buyers of these integrated solutions would be entities that have a holistic view of the patient. Physicians compensated on a fee-for-service basis have little economic incentive to manage overall costs down. Health insurers are typically a step removed from patients and, for all their aspirations otherwise, may be little more than claims processors. Pharma and device companies are pinning their hopes on "economic customers" that gain financially from improved patient care and that have the capability to align physicians around protocols which achieve these outcomes. But, at least in the U.S. healthcare system, few of these economic customers actually exist yet.
What can pharma and device companies do about this conundrum? The answer lies in aiming first for footholds, not the ultimate prize. My piece for Forbes explores what the footholds might be.
Stephen Wunker is the Managing Director of New Markets Advisors. Read more about our perspectives on healthcare.
Industries that might appear vastly different on the surface can show powerful parallels on close examination. Business model innovation in genetic testing and electric cars shows how new kinds of intermediaries often arise in new markets. As they build strong strategic positions for themselves, these intermediaries can also turbo-charge the growth of markets by removing several common barriers to adopting bold innovations. Read about their lessons in my piece for Forbes.
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Walgreens, the American drugstore giant, is a 110-year-old institution in a very well-established industry. But that hasn't stopped it from upending the competitive game by using under-exploited assets to create new markets. In doing so, it has built defenses around profitable core businesses while generating high-potential sources of growth. Read more in my Financial Times article (subscription required).
Stephen Wunker is the Managing Director of New Markets Advisors and Author of Capturing New Markets: How Smart Companies Create Opportunities Others Don't.
This week marked the annual meeting of America's Health Insurance Plans, an event that drew an unloved group of executives to commisserate about poor margins, upheaval following health reform, and even a group of protesters waving placards calling for the industry's abolition. As trade shows go, it was a real downer. Yet the story of a handful of winners bears strategy lessons for companies in any industry grappling with fundamental change.
Strategy for health insurers in this environment requires a keen sense of how the industry will evolve. Assuming that the courts do not strike down the Affordable Care Act (ACA) underlying U.S. health reform, by 2014 insurers will have to offer a minimum level of benefits, at very transparent prices, in an electronic exchange that facilitates comparisons. In other words, their core products will be commoditized. While reform will drive many of the uninsured to be new customers, they will create scant profits for the industry.
Amid this mess, there are three categories of winners. One group consists of large insurers such as UnitedHealth and Aetna have been getting into adjacent businesses like healthcare IT, disease management, and clinical decision support. The businesses derive advantages from the data, physician network, and immense customer bases that these companies have, while helping them differentiate the quality of their insurance offerings through promising better health outcomes. Already, these businesses are producing substantial profits for the early leaders.
Another set of winners are IT companies facilitating data mining and integration of care provision. Health insurers, hospitals and physician practices were historically discrete silos that scarcely communicated with each other, but the management of complex, chronically ill patients benefits hugely from coordinated care. If insurers are to have a hope of profits with the transparent pricing under the ACA, they will need to tightly manage these costly customers. The trade show's exhibit floor was a scrum of IT booths jostling for share in this rapidly expanding market.
A final group seizing the upside are hospitals that are leading integration with physician practices to form "Accountable Care Organizations" that will bear the financial risk, and benefit, of effectively managing disease. Some insurers have tried to lead the creation of ACOs, but except in certain circumstances (e.g. some rural areas, states dominated by a single Blue Cross plan, plans that own hospitals) they lack a large share of the total number of patients served by a given group of doctors, so they are supporting the costly creation of a care management organization only to reap a small portion of the financial reward. They will learn about ACOs' dynamics from their efforts, but it is hard to see them scaling up these programs.
If they are not in one of these groups, many health insurance companies seem lost at sea. They are tweaking their model, but the model is broken. Differentiation will come from providing higher quality care, which in healthcare usually results in lower costs (due to avoided hospitalizations and the like). Insurers claim that hospitals cannot do what insurance companies can -- they will not take out insurance licenses, mine data, or sell to employers. But that misses the point. Those activities are commodities; they offer little way to differentiate. If companies are not seriously invested in IT or very tightly integrated with a set of hospitals or physician practices, they are relatively inter-changeable.
For readers outside the healthcare industry, forgive the long discourse above. U.S. healthcare is complicated. Let's look at the implications for any firm:
- To innovate, a company will benefit from integration across steps in the value chain. Insurance plans that own hospitals and physician practices have been noted innovators in their industry. In a rapidly changing industry with many steps in the value chain, intense competition among fragmented players may not lead to innovation, as those players will lack the scale to integrate across value chain steps to force change. Both Republicans and Democrats have claimed that competition in the insurance industry can lead to innovation, but they get it wrong -- until consolidation occurs, competition will lead only to rock-bottom pricing on uninteresting offerings.
- Focus on the toughest problems of an industry, because that is where serious money can be made from producing better solutions. Healthcare IT has long been horrendously complex, but it is a huge need.
- Be close to the customer. Hospitals and physician practices are in the cat-bird seat because they have the power to change the quality and cost of care. Health insurers interact with patients at arms length, and they lack the personal contact that is often essential to changing lifestyles and ensuring compliance with treatment regimens.
- Have scale in a niche. Marshfield Clinic is a modest-sized health insurer and physician practice group, but it is a giant in rural Wisconsin. It has had the scale in those small communities to invest in the health of the overall population and knit together tiny physician offices through world-class IT systems. By contrast, many health plans in California are far larger than Marshfield, but the market is keenly competitive and they have lacked the power to create change among many physician practices and hospitals.
Health insurance is a complex, competitive, and highly regulated industry. It's tough to win. But those who have managed to triumph in this environment provide a roadmap for capturing the upside of new markets.
Click for more of New Markets' thinking on healthcare. Click to learn about the book Capturing New Markets: How Smart Companies Create Opportunities Others Don't
Today's Wall Street Journal contains a special report on innovation in healthcare, under the banner headline "The Time to Innovate is Now." What follows is an uncontroversial call for more innovation in response to escalating healthcare costs, along with a description of several disconnected but novel programs. What's missing is an assessment of why new markets take so long to get moving in healthcare: the system is not aligning incentives for innovation.
The underlying problem is one afflicting many industries slow to take up promising innovations; healthcare in the United States is incredibly fragmented. Not only are there health insurers, hospitals, medical practices, independent physicians, vendors, and countless others, but there are many competing entities in almost all these categories. On the plus side, fragmented systems can provide new ideas with tiny footholds willing to try new things. The downside is that they can hinder the rapid spread of learnings. Not only are there poor mechanisms to spread effective ideas (the "agricultural extension" model has been embraced only tentatively in healthcare), but financial incentives for healthcare change are seldom aligned. Innovations may help insurers but place new burdens on physicians, and so forth. All this misalignment leads some healthcare observers to argue that the cure for healthcare's ills isn't bold new innovation, but rather broad adoption of innovations already trialled by brave pioneers.
This view may be cynical and extreme, but there is truth to it. America's healthcare cost crisis could be largely solved if high-cost states could equal the spending of lower-cost states such as Minnesota (where health outcomes also exceed those of high-cost states, even after making adjustments for prevalence of disease). This sort of opportunity can be common in disconnected systems. For example, greenhouse gas emissions from homes and buildings could be slashed 30%, at no net cost, if the building industry would adopt energy efficient technologies and methods.
So, how can healthcare align incentives? We are not about to revamp the U.S. healthcare economy (again). However some organizations, such as Medicare and Blue Cross of Massachusetts, are experimenting with "global payments" to a single entity such as a hospital to coordinate all care for a patient and align providers' incentives accordingly. This trend, as it gains strength, at last gives the recipients of these payments the financial leverage to force other stakeholders to align behind innovations in care. For innovative companies wishing to grow through reducing healthcare's costs, the answer is to become one of the answers that hard-pressed health systems adopt as these payors hand the systems the power that global payments create.
This strategy requires companies to generate a track record, quickly, with the sort of organizations these health systems will look to for validation of a new solution. Such "reference customers" need to be similar to the types of health systems that will be forcing through change. A reference customer like Massachusetts General Hospital or Kaiser Permanente may be too unusual -- they are highly sophisticated, with advanced IT systems and thousands of physicians. Tiny medical practices are unrepresentative as well; these small groups are unlikely to receive global payments from payors and will find it increasingly difficult to survive. This leaves a reasonably small number of large group practices of around 50-200 physicians as the vanguard of change. These practices will be some of the most important recipients of global payments, and they may be far faster-moving than some of healthcare's behemoth providers.
To build a track record, companies need to generate data, but they also need to iterate their model given the fast changes in this industry. Accordingly, they need to adopt a two-track approach with clinical trials following fixed protocols, accompanied by "commercial trials" with highly flexible approaches. The clinical protocol may well be out-of-date by the time the study concludes, but it will generate useful data nonetheless which a commericially up-to-date organization can flog relentlessly.
This two track strategy, aimed at the middle tier of the market, is applicable in fields well outside of healthcare. For instance, makers of energy efficiency technologies could follow the same approach with mid-sized architecture and building firms. The strategy lacks the sizzle of partnering with the sexiest large firms, and it costs more than a single-track approach. Yet it is the pragmatic way to tackle disconnected systems poised for rapid change. Just as in baseball, aiming for a couple of well-timed base hits can be a far more effective and reasonable goal than to swing for the fences.
Click for more of New Markets' thinking on healthcare.
Niche environments create space for new life forms. Like an undersea volcano surrounded by bizarre creatures, commercial niches enable new types of business models and enterprises to flourish. The niches also provide a foothold from which these businesses can step into larger and more competitive markets.
The challenge about niches is that they are abundant, and some will be as eternally isolated as those undersea volcanos. Picking your niche is a critical discipline. Four rules illustrate how to do this in a rigorous way.
- Target Customers Overserved yet Undershot by Existing Offerings -- One Medical Group is a new concept in primary care medicine. For a few of a few hundred dollars a year, it enrolls patients in exclusive practices that provide extensive personal attention, same-day visits, lengthy consultations, and excellent customer service. But it is not for everybody. If you have a bevy of chronic conditions requiring tight coordination of a team of specialists, go somewhere else. One Medical is a great proposition for relatively healthy people who do not want to wait three hours for a 12 minute appointment. It may not scale to serve millions of patients, but its niche is plenty big to be attractive. Not only does the model offer an answer to over-stretched primary care physicians facing a wave of newly insured patients, workflow changes, and an older, sicker population, but it may also offer a route for small health insurers to escape an increasingly commoditized industry in which they have fundamental disadvantages.
- Target a Simple Buying Decision -- Don't try to be too clever. When I started one of the first mobile marketing companies in 2000, we fervently believed that we had a great way to market retail special offers to consumers. It was a pretty good idea, but 10 years too early. Retailers would have to align staff from a wide range of functions to give the proposition a try. A rival firm targeted radio stations that wanted to give listeners a way to interact with the DJ. This was an easy decision. It may not have held out promise to be a large market, but it was a fast place to get started that also legitimized the then-new idea of sending text messages to a company rather than an individual. Similarly, healthcare IT firms struggled for years due to the complexity of selling to medical practices, and the ones who gained traction first were those who focused on sending prescriptions electronically to pharmacies -- a simpler idea that the pharmacies could help turbo-charge.
- Avoid Network Effects -- Zopa had its first office next to my mobile marketing start-up. Like that company I founded, Zopa is still around but it never really scaled up. It was one of the first firms to pioneer peer-to-peer lending, where people with a bit of money to invest could lend funds directly to consumers who were scored according to their credit rating and other factors, bypassing all the overheads of banks and credit cards. This is an interesting idea, but it faced a chicken-and-egg conundrum. Does it build its list of borrowers first, or its lenders? Will it attract the worst borrowers? Eventually businesses can surmount these challenges, and the company is now lending over GBP 5 million per month. But it is not a great business strategy, particularly for a firm that is already established, seeks to re-position itself, and has an existing cost base it needs to cover.
- Embrace Small Competitors but Avoid Big Ones -- Small competitors can help to educate a marketplace about a new category, and they provide reference points for competitive bids which supply new buyers some reassurance. Big competitors seize the limelight, give away free trials to show they have customers, and are often the first choice of purchasing managers who do not typically love to take risks. Competition can be good, provided that it is the right type of competition that creates new market space.
Picking a niche is an endeavor where patterns of success are invaluable. In addition to the principles laid out above, consider who has succeeded and failed in creating niches in your industry. What rules can be discerned?
There is seldom one right answer to picking a niche, but there are definitely wrong answers. Thoughtful attention to these dynamics up-front can create large payoffs down the road.
Click for more of New Markets' thinking on business models and early movers.
It is depressing to Google "health insurance innovation." Most links involve rants against a powerful industry, while some make equally spurious claims that public payers such as Medicare have played a scant role in healthcare innovation. There is far too little published about how a huge industry has actually innovated, and still less about what it can do now in response to the major innovation challenges posed by U.S. health reform. This industry's tough situation, and its potential responses, offer lessons for innovators in many other fields.
Due to a variety of provisions in health reform (more formally, the U.S. Patient Protection and Accountable Care Act), the old business model of health insurance is seriously threatened. Plans will become more consistent in their minimum levels of benefits, reduce the ways in which they diverge in pricing, and list their features on an online Health Insurance Exchange. Many will need to reduce their marketing and administrative expenditures. In short, the old ways of doing business will become seriously commoditized. The health insurance industry was not particularly attractive to begin with (operating margins under 5% are the norm), so there is a big need to re-think the business model.
A first step is to look for clues from past health insurance innovations. Health Maintenance Organizations (HMOs), while derided for limiting care, succeeded in reducing the growth of healthcare costs, and using technology to monitor quality in new ways could surmount some of the challenges HMOs encountered in previous decades. Consumer-Directed Plans, such as Health Reimbursement Accounts, led at least "healthy and wealthy" consumers to make better care choices. Integrated Delivery Networks (and their first cousin, Accountable Care Organizations) such as Kaiser Permanente or the Veterans Administration have provided outstanding care for relatively little cost due to coordinating care among physicians, putting doctors on salary rather than fee-for-service contracts, and investing heavily in disease prevention. Overseas, South Africa's Discovery Vitality has been a world leader in using financial incentives to lead members into healthier behaviors. Bangladesh's Grameen Health uses an innovative care delivery model to bring the right people in for care in a low-cost setting. Nigeria's Hygeia HMO contracts directly with large employers to link them with its member hospitals and medical practices, even going so far as to placing clinics on-site at many workplaces to help monitor and treat chronic as well as acute conditions.
Next, health insurers should consider asymmetric competitors. An emerging trend is for large employers to cut out insurers through self-insuring their risks, using Third Party Administrators to process claims, contracting directly with medical providers such as local hospitals, and placing clinics on-site. Another approach has been taken by Washington State's Qliance, a group of medical practices that offers individuals the equivalent of health insurance without the insurance firm -- it charges a monthly membership fee for use of its clinics. A third tack has been deployed by some of the big national carriers like Aetna, rolling out sophisticated decision-support software for physicians that may give it a means of steering members into higher-quality, lower-cost treatment protocols (oftentimes in healthcare, a minimally-invasive approach that treats conditions properly the first time around is both better medicine and better business).
Then insurers can consider their options, which depend on their starting point. Big national carriers can invest in IT-centric tools that use their scale and massive databases of treatment outcomes to maximum advantage. They can offer both employers and individuals potentially better care at lower cost. Local players with modest scale but large market share in particular states (e.g. many of the Blue Cross plans) can force providers into relationships where they are compensated a fixed amount per patient and provided quality-based incentives -- this is a more decentralized approach to care than the national players might take, but likewise has potential to both improve medicine and lower cost. Third parties such as Pharmacy Benefit Managers might turbocharge their efforts to contract directly with employers, helping to coordinate care on their behalf partly through remote monitoring technologies, call centers, and new proprietary technologies (witness Medco's high-profile investment into genome-based diagnostics).
This leaves the players who lack either national or local scale. There are plenty of these firms, many of which are non-profit, and they are in a tough spot. These companies need to pick their shots and focus. For instance they could concentrate on certain professions, such as long-haul truck drivers, with tailored solutions. The problem is that health reform limits their ability to price differentially for taking on people with more health risks, although several yet-to-be-issued regulations may give them some ability to do so. Alternatively they may cater to individuals through re-framing their offerings beyond traditional healthcare, such as through offering more types of services through local gyms or combining health insurance with savings and investment accounts. Either way, they need to change the game they are currently playing.
With healthcare costs continuing to rocket upwards, and US healthcare quality often lagging other industrialized countries, there is ample headroom for health insurers to innovate. The key is to make a handful of strategic choices about where a firm's competitive advantage lies, and then to maximimize the use of financial, technological, and business model tools to stake out ground before a host of wounded rivals follow. In a business that revolves on technology, scale, and trust, first-mover advantage can be very real. It is high time for action.
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It has become perversely fashionable to beat up on America's capability to compete vs. China. The U.S. government is often seen as too short-sighted and timid to bolster American capabilities in key sectors critical for the 21st century. By contrast, China seems to be the entrepreneurial visionary. Yet in at least in two very high-profile fields, the conventional wisdom seems dead wrong.
Energy firms such as GE have lavishly praised China for investing big money in making the country the global leader in renewable technologies such as solar photovoltaic (PV) cells. While there are definitely worthy aspects of China's energy policy -- such as its clarity in how things are regulated and what government's position will be over the long-term -- much of the government's funding has gone to sudsidize as much as half the cost of installing renewables. Unsurprisingly, this spending has quickly made China the world's biggest renewables market. The large local market, strong local talent, and generous financing has led to China also becoming the global leader in new markets such as solar PV manufacturing.
There is little doubt that PV will become a large industry, so China's position in PV may create many manufacturing jobs (at high initial cost). But what about innovation and long-term profits? Without these wins, market creation can create growth in the near-term but forsake important future platforms. In another era, emerging markets such as China gained millions of jobs in garment manufacturing, but firms such as DuPont continued to dominate the high-value areas of textile science. While China focuses on manufacturing PV, Silicon Valley is shifting to advanced technologies that can be licensed to the Chinese. For instance, after installing a 10 megawatt production line in 2008 a start-up called Innovalight decided it was more sensible to license their critical technology so that it could appear in many manufacturers' PV cells. This is both good business sense and a way to retain the highest value jobs in the United States. To an analogy from Professor Clayton Christensen and the hockey great Wayne Gretzky, China is investing billions to stake where the puck is, while Silicon Valley has the flexibility to skate to where the puck will be.
The United States has a checkered history of supporting innovation, but in bolstering the spread of healthcare IT the government is clearly calling the right plays. Rather than investing vast sums in an enormous national healthcare IT system (as the UK did, only to scrapped the failed project), it has taken a far leaner, more flexible, and generally more cost-effective approach. The government is subsidizing the cost of healthcare IT installation by physicians, but doing much else besides. It is creating beacon communities to serve as reference customers for wary doctors, showing the value of adopting these systems. It is borrowing from the agricultural extension playbook by creating local extension programs devoted to surmounting everyday implementation issues in doctors' offices. The government is also partnering with industry to create standards for data interchange between software systems. Another initiative has the government copying from the weather bureau, of all places, in placing a huge amount of data online, in machine-readable format, and creating a software developer community through meetings and competitions to leverage this data in a host of ways that only a few dreamers can conceive of today. In short, most of these initiatives are dirt-cheap, leverage government's unique position, and rely on entrepreneurism to generate wave after wave of new markets using these resources.
The great and challenging thing about new markets is that the innovation never stops. By investing too much in creating a new market that seems close, government can overly influence entrepreneurs to lose focus on the great new markets of the slightly more distant future. Government can play a critical role in market creation, but that role should be one that relies on entrepreneurship to discern where the next big opportunities lie.
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Old habits change slowly. Just as married couples can struggle for decades to change how they interact, partners in a business ecosystem have a tough time altering engrained behaviors. Without a specific impetus for change, the parties revert to familiar patterns. Habits become habitual because they work (if only just) and the upfront investment in changing well-understood systems may not be justfied by the long-term, uncertain returns.
The IT consulting firm TCS recently illustrated how this story is playing out with healthcare IT. Despite substantial investment in systems (to be augmented soon in the United States by people claiming the $17 billion stimulus provided for healthcare IT under the 2009 HITECH Act), a TCS-funded study showed that only 23% of healthcare organizations are fully interoperable with external parties and have gone paperless in care management. Doctors may be putting their filing cabinets onto disks, but they are not using that data to change their interactions with other physicians, health insurers, patients, or other key stakeholders.
This is a common phenomenon. As new markets typically develop, first an infrastructure is laid in small patches, then it is used in disconnected ways, and over time the patches are woven together into a powerful, transformative platform. The Internet developed this way, as did railroads and health systems. What speeds change is a highly-motivated party that can fund the removal of roadblocks, provide a clear roadmap, and incent entities to adapt. The change does not initially happen in a wholesale fashion, but rather in focused areas of immediate need. For instance, large organizations and universities were some of the first institutions to get people to use e-mail broadly because they had these powers, and they created a critical mass of people online that made it attractive for others to struggle with dial-up access until they heard an upbeat "You've got mail!"
Firms charting a healthcare IT strategy can leverage this pattern. First they should map how healthcare IT may transform relevant areas of care and the role of specific stakeholders. Then they should seek particular applications where they have both the power to make change happen and the means to benefit from being a shaper of the new landscape. The HITECH Act, and a near simultaneous move to a new procedure coding system called ICD-10 that vastly expands the detail in medical records, creates more impetus for change now than ever before. The strategic priorities of other healthcare stakeholders -- resulting from both health reform and economic pressures in the industry -- make them potential partners in making this change happen.
Healthcare IT may transform the practice of medicine through:
- Empowering organizations to make doctors follow evidence-based guidelines, rather than follow their highly idiosyncratic preferences that still have an inordinate influence in the healthcare system. Organizations wielding particular influence would be health insurers and certain large physician practices (some of the most motivated practices may be "Accountable Care Organizations" like Kaiser Permanente, which assume risk for patient health, deliver care, and coodinate among physicians. National health systems like Britain's NHS are also key players, of course)
- Gathering data about the medical outcomes resulting from use of these standard protocols
- Enabling interested parties -- such as insurers, disease management organizations or even patients -- to better coordinate their care through centralizing records and making treatment regimens transparent to all physicians involved in a patient's care
- Changing the way insurance is bought, through enabling more transparency about what people are buying (and facilitated by health reform reducing differentiation among plans while simplifying the purchase process)
- Creating tools for employers to motivate their workforces toward wellness goals and potentially monitor progress
- Closing the loop between the doctor's office and everyday life, through integrating data from remote monitoring devices into physician records
- Empowering people who can interpret and explain all this information to patients. These people may not be primary care physicians, who will be overloaded with new patients due to health reform and other pressures, but perhaps alternative parties including health insurers or their representatives, such as drugstore-based nurse practitioners
From this list of potential implications from healthcare IT, three parties stand out as having the motivation, resources, and power to push through change in focused areas. Health insurers (and the self-insured employers they sometimes represent) can make healthcare IT transform care for certain patient types they prioritize, such as those undergoing cancer treatment or therapies for chronic disease. While physicians may resist a broad-reaching change in their work practices, for well-defined patient types and with the right incentives they might begin to alter long-standing habits. Health insurers could differentiate themselves on their quality of care while also reducing cost (as Japanese carmakers demonstrated long ago, high-quality work not only creates better cars but also has lower costs than production with substantial errors and re-work). Another party would be Accountable Care Organizations or health systems, which could have motivations similar to a health insurer and sometimes more leverage to get physicians to collaborate. A third party that could create change are suppliers (such as medical device or pharmaceutical companies) catering to certain disease states where the supplier either needs to differentiate from many competitors or stands to gain substantial rewards through pricing its products based on medical outcomes attained.
Healthcare IT strategy needs to look at the end-state of how healthcare will be delivered, rather than at narrow imperatives about how companies must react to new requirements. This is one of those few occasions that lay down a new infrastructure for an industry. It enables old habits to be discarded, bit-by-bit yet irrevocably.
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