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Disruptive Innovation: A Complexity View - Part 1

Posted By Tom Bigda-Peyton, Friday, September 5, 2014
A recent PlexusCall featured the recent controversy between Dr. Jill LePore and Clay Christensen on the topic of disruptive innovation. Three panelists shared their experience with, and perspective on, Christensen's theory: Peter Jones, David Hurst, and Dr. John Kenagy.

Dr. Kenagy said that successful organizations are designed to keep doing what they are good at doing. This prevents them from seeing, or fostering, innovations that may be disruptive (game-changing). In healthcare this is important because existing organizations, especially those that are well-known and established, may miss or suppress a "game changing" innovation that could provide a breakthrough on Kenagy's area of focus, generating "more care at lower cost."* In order to support disruptive innovations in healthcare, we need to create "safe places" in which to experiment toward better and even disruptive solutions to healthcare's problems. Kenagy went on to elaborate on his methods for creating this kind of "learning line," or "safe to fail" lab in healthcare organizations.

However, healthcare also seems to be a special case of disruptive innovation. As Kenagy and other speakers noted, the notion of "disruptive" innovation suggests the advent of a new product or service that disrupts the status quo. But what is the "product" of healthcare? Kenagy posits that we have one product in healthcare: the health of the patient in front of us. This is a complex challenge, one that suggests a different set of variables than those confronted by Apple or Google.

David Hurst and Peter Jones noted additional dimensions of the healthcare challenge which differentiate it from other industries. Jones suggested that the popularity of the "disruptive" idea may lead us down the wrong path, especially when it comes to healthcare. Do we want medical device startups competing for funding on the idea that they have a disruptive innovation, when a better solution may be that a consolation of companies all have parts of an overall solution that would be better than any of them can produce on their own? The current funding model may suboptimize in terms of overall problem-solving and advancing the health and well-being of individuals and the wider society. For these and other reasons, Kenagy asserted that "adaptive" innovation may be a more appropriate term than "disruptive" innovation for healthcare.

How does a complexity view help us develop an optimal US healthcare system? Let’s assume that healthcare is a complex adaptive system. How do we represent our theory of the system itself? What are the metaphors of change that can help us navigate the journey of disruptive innovation in healthcare? The panelists agreed that organic metaphors, such as the butterfly effect or the self-organizing capacity of flocks of birds, work better than mechanistic metaphors or system dynamics diagrams. If we want to mimic nature, the panelists agreed, we need to promote conditions for trial-and-error experimentation, such that the actors in the system can use a trial-and-error pathway toward innovations that may become "disruptive."

Are there current efforts in healthcare to mimic nature’s process of self-organization and evolution? What can we say about the conditions which foster this kind of process in human organizations? Viewing the situation through a complexity lens may help.

When we think about nature as a metaphor for self-organizing and evolution, we need to think about the conditions in human organizations that promote self-organization. We would like to highlight three:

• Optimal uncertainty;

• Optimal agreement among stakeholders; and

• Common language and common framework for complex problem-solving.

Following the Stacey Matrix (below), "optimal uncertainty” refers to a middle zone between chaos and simple problem solving. There is uncertainty but not so much as to paralyze the organization; there is familiarity but not so much as to make the problem seem routine. Optimal agreement is a similar concept, in which we find a diversity of views but also enough commonality to bind, or hold, the group together. Finally, we believe the capacity for self-organization is fostered by a common language and framework for complex problem-solving, such as the ability to differentiate between simple, complicated, and complex problems and the capacity to match appropriate methods to each.

How does all of this apply to healthcare? We will take up this question in our next post.


Tom Bidga-Peyton is a Senior Consultant with Plexus Institute. Tom's work focuses on widening and accelerating the pace of improvement in individual, organizational, and large-system change initiatives.

Tags:  disruptive  innovation 

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