A physician-friend of mine is raving about The Innovator's Prescription by Clay Christensen and team. My friend tells me it's the best book ever written on health care, and has even sent me a copy via Amazon.com as an early birthday present (thank you!)
Indeed, the author himself claims it's "the first book ever that actually presents a plausible roadmap to make health care affordable in this country," and the New York Times seems to agree. (I am told, btw, that Mr. Christensen himself has Type 1 diabetes.)
My copy has just arrived, and I am thumbing through it, whilst conducting the requisite Google searches, trying to understand just what is so revolutionary in these 426 pages.
According to the influential Health Care Blog, "the authors present many insightful ways to analyze and understand the dysfunction of the U.S. health care system," including:
- Describing the two major "enablers of disruptive opportunities" in health care—
- Technologies that will enable less skilled individuals to do tasks that previously required specialized expertise (like med assistants taking on a bigger role), and
- Business models allowing care to move from centralized locations (hospitals and doctors offices) to distributed environments (home, work and community).
- Explaining the critical role of standardized personal electronic health records (why do we REALLY need these?)
- Introducing a new terminology that differentiates between intuitive medicine, empirical medicine, and precision medicine
- Describing the three key elements for innovation: the technological enabler, business model innovation, and something called a "value network"
- Explaining in detail the need for systemic integration in health care
- Describing the type of medical practice required to diagnose and treat a range of chronic diseases
As a person living with a chronic illness who's just trying to understand how our care can be improved, that final point certainly caught my eye. By cheating a little (looking up "diabetes" in the index), I immediately found a fascinating section in which the authors dig into "behavior-intensive diseases with deferred consequences" (that's us!!)
Notably, the authors say: "Patients with behavior-intensive diseases can generally formulate better algorithms of care through trial and error than their physicians can." What say you, Fellow Type 1s?
Using various charts and figures, the authors actually illustrate which chronic diseases are more "rules-based" (can be treated with straightfoward empirical medicine) versus "intuitive" (where there's a lack of clarity in diagnosis and treatment). The other important factor is how "technology-dependent" each illness is. You might be interested to know that Type 1 diabetes falls in the high-everything quadrant (requiring immediate behavior change, lots of technology, and having immediate health consequences.) Type 2, on the other hand, is lower on the technology scale and has "deferred health consequences." For this reason, and because effects tens of millions of people, it falls in the "Chronic Quadrangle" largely responsible for "the crushing costs" of healthcare in this country. But we knew that already.
In short, I think this book does a great job explaining what EXACTLY is wrong with our healthcare system in this country -- in a pretty readable fashion, if you're used to slogging through descriptive non-fiction. It also apparently offers very valuable insights about how to fix our system.
Admittedly, not everyone agrees that it's the best-ever book on healthcare; another doctor buddy of mine claims that title goes to a book called, "Redefining Health: Creating Value Based Competition on Results." Reading it was apparently "a life-altering experience" for him (!)
Nonetheless, I'm excited to start slogging through The Innovator's Prescription myself -- right after I spend a week or so wrangling with our family's new insurance provider to make sure they get us on board, and then arguing with our old and new mail-order pharmacy services over who's responsible for transferring all my prescriptions over. Viva la Reform!