On March 16-18, 2011, thought leaders from mental health, substance use, and the larger health care field came together in New Orleans to examine disruptive innovation and its implications for our field in the era of dramatic health reform. What are disruptive innovations? How do we create and encourage them? And how do we lead the field as they take root?
Disruptive Innovation’s Power to Upend Markets
In the 1990s, Harvard Business School professor Clayton Christensen coined the term “disruptive innovation” to describe a simpler, cheaper product or service that ultimately upends an established marketplace. The new product or service starts out in a rudimentary form and is initially targeted for delivery to previously unserved or underserved groups. As the new product or service takes hold, it is refined and ultimately displaces more established products or services that are more expensive, more complex, and unable to adapt.
A useful example of disruptive innovation is the personal computer, which has made computing accessible and affordable to most Americans. In the 1970s, Digital Equipment Corporation (DEC) and IBM were leaders in the computing business, a marketplace that was limited to those few with sufficient resources and skill to buy and operate mainframe computers. Visionaries at IBM took up the recently invented microprocessor and created a new business model that brought an initially modest product (relative to powerful mainframe computers) to a brand-new market – the home user. DEC was not able to make the transition to personal computing and did not survive.
Disruptive innovations have been documented throughout the business and technology fields. More recently, the ideas have been compellingly applied to health care. Christensen and his colleagues’ 2007 book, The Innovator’s Prescription: A Disruptive Solution for Health Care, provides a thorough overview of the concept, demonstrating how disruptive innovations are making and will make health care accessible and affordable for most people.
Applying Disruptive Innovation to Behavioral Health: The 2011 Summit
As we in the behavioral health field scramble to educate ourselves and begin conceptualizing how we must change to survive this era of health reform, disruptive innovation offers a powerful framework to ground our thinking.
At ACMHA’s 2011 Summit, we will dive into disruptive innovation and explore ways to harness its power to make behavioral health care more accessible and affordable in a new era. Using the language and framework of disruptive innovation, we will examine key questions such as:
- What are the technological enablers that will routinize diagnosis and treatment, conserving highly expensive, skilled professionals for atypical cases and maximizing the use of providers with different training?
- What new business models in the provision of care, insurance, and reimbursement will make behavioral health care less costly and more accessible?
- What are the key elements of new value networks (i.e., the suppliers, retailers, and consumers that make up the context in which business models operate) that will allow disruptive innovations in behavioral health care to flourish?
- What are the opportunities – through health reform and elsewhere – to facilitate disruptive innovation through current and new regulations and standards?
We will look not only at what will be but what is – that is, those areas of disruptive innovation that are already shaking up the behavioral health care field and health care in general. These include employing peers and community health workers as providers, establishing personal health records, and providing collaborative care for managing behavioral health conditions in general medical settings. We will talk about how to recognize a disruptive innovation when you see it and how you might go about developing them yourself.
We will also focus on the critical role of leadership in an era of disruptive innovation. Across all fields, established leaders often fight disruptive innovations, with the desire to hang on to the status quo. We will examine ways that we can use our leadership instead to support the adoption of disruptive innovations in behavioral health and the larger health care field.
- Mental Health Weekly, Volume 21, No 12 (March 21, 2011)
- Behavioral Healthcare, “ACMHA Names Four 2011 Award Winners” (March 23, 2011)
Summit Presentation Slides
- What Does it Take to Lead? Developing Organizational Strategies to Address Disruptive Innovation in the Market – Monica Oss, Open Minds
- Healthcare Reform And Disruptive Innovation: Oxymoron or We Told You So? – Dale Jarvis, Dale Jarvis and Associates, LLC and Chuck Ingoglia, National Council for Community Behavioral Healthcare
- Improving Lives and Capitalizing on Emerging Opportunities – Pamela S. Hyde, JD, Substance Abuse and Mental Health Services Administration
Designing and Selling a Disruptive Innovation
On the final day of the ACMHA 2011 Summit, participants gathered in an Innovation Marketplace. There, six “vendor groups” presented new “products” for treatment, support, and/or service delivery that in one or more ways were disruptive to the status quo of today’s behavioral health marketplace. Following their presentations, all participants had the opportunity to invest in one or more products with the “ACMHA bucks” provide to them as they entered the marketplace. Trading was spirited and, befitting American marketing models, offers of bonus gifts and new technology were made to entice investors.
Notes regarding each of the innovations traded are available from the links below.
- Wellness Village
- Community Care Organizations
- Service Without Walls
- Store Front Wellness
- Web-Enhanced Person Centered Assessment Tool (WEP-CAT)
- Changing Paradigms of Behavioral Health Services Research and Recovery
Research Poster Presentations
- Consumer Attitudes Toward Participation in Clinical Research
Allen S. Daniels, EdD and Lisa C. Goodale, MSW
- Psychiatric Nurse Practitioners: Shaping Effective Innovations in Mental Health Treatment
Kathleen R. Delaney, PhD, PMH-NP
- Barriers in Implementing Evidence-Based Collaborative Care for Depression: Providers’ Perspectives on Comfort and Difficulty Delivering Depression Care in Primary Care
Jennifer L. Magnabosco, PhD, Michelle Seelig, MD, Lisa Rubenstein, MD, MSPH, Edmund Chaney, PhD, Ellzabeth Yano, PhD, Andrew Lanto, MS, Barbara Simon, MA, Jeff Spina, MD
- Measuring Chronic Disease Care Delivery: A Scorecard for Primary Care Physicians
John C. Wadsworth, BS
- Self-Help Quality Improvement as a Disruptive Intervention
Gregory B. Teague, PhD
- Pierce County, WA Crisis System Transformation
Cheri Dolezal, RN, MBA
- Before We Disrupt, Have We Transformed?
Crystal Blyler, Chuck Lupton, Steve Leff, Clifton Chow, Grace Gonzalez, Ben Cichocki, Dow Wieman, Terry Camacho-Gonsalves, Laysha Ostrow
- Using New Technologies to Support Treatment and Recovery
Mike Boyle, MA and David Moore, MS
- Creating Replicable and Sustainable Peer Support Services
Beth Epps, MEd and Chyrell Bellamy, PhD, MSW
- Behavioral Health Community Indicators: A Disruptive Innovation for Measuring Effectiveness of Service Providers
Lynda Frost, JD, PhD; Susan Stone, MD, JD & Tara Powell MSW, MPH
Getting Up to Speed for Summit
We will hit the ground running at the 2011 Summit. With so much content to cover, we will provide only a brief overview of the key concepts before diving into strategic discussions. Here are some things you can do to get up to speed before Summit:
- Listen to Keynote Speaker Paul Keckley’s Pre-Summit Webinar on Disruptive Innovations and Behavioral Healthcare (Recorded 03/03/11)
- Read “A Letter to ACMHA Members and Friends: What is a Disruptive Innovation and Why Should I Care?” by Dale Jarvis
- Plan to participate in the pre-Summit webinar this winter, which will cover the basics on disruptive innovation and provide initial food for thought on its applications in behavioral health.
- Read the main source — Clayton Christen et al’s 2007 The Innovators Prescription – A Disruptive Solution for Health Care, or try John Kenagy’s brief summary of the issues at www.kaisernetwork.org/health_cast/uploaded_files/kenagy.pdf.