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• W2111640356 abstract "Disruptive technology is a term coined by Harvard Business School professor Clayton M. Christensen to describe a new technology that unexpectedly displaces an established one. His 1997 best-selling book, The Innovator’s Dilemma separates new technology into two categories: sustaining and disruptive. Sustaining technology relies on incremental improvements to an established technology. Disruptive technology lacks refinement, often has performance problems because it is new, appeals to a limited audience, and may not yet have a proven practical application. For example, Alexander Graham Bell’s ‘electrical speech machine’, now the telephone. Of relevance to healthcare is the fact that large corporations (i.e. Department of Health) are designed to work with sustaining technologies. They excel at knowing their market, staying close to their customers, and having a mechanism in place to develop existing technology. Conversely, they have trouble capitalising on the potential efficiencies, cost-savings, or new marketing opportunities created by low-margin disruptive technologies. Christensen demonstrates how it is not unusual for a big corporation to dismiss the value of a disruptive technology because it does not reinforce current company goals, only to be blindsided as the technology matures, gains a larger audience and market share and threatens the status quo (http://tinyurl.com/38lury5). Over the last three years, a series of articles in BJHCM have introduced the conceptual equivalent to ‘disruptive technology’ into our understanding of how healthcare demand behaves through time (see Jones, 2009; 2010; 2011a–b; 2012 for further references). The existing incremental technology (demographic-based growth) has been demonstrated to fail in the real world and unheard of ‘disruptive’ concepts such as ‘cycles’, ‘step-like changes’ and ‘wavelets’ have been proposed to offer better insight into how costs behave over time. The combined and interactive effects of the environment (weather, air quality, infectious outbreaks) have been proposed as a major contributing factor in these disruptive changes and explain why it is almost impossible to run a balanced healthcare budget. Hence, changing commissioners from primary care trusts (PCTs) to clinical commissionig groups (CCGs) is mere window dressing based on the old incremental ‘technology’ and its hidden assumptions. For those of you who are bewildered, Figure 1 gives an illustration of the issues at stake. In this figure, weekly ambulance call outs across England have been compared pair-wise for the same week of the year, i.e. first week Figure 1. Category A+B ambulance call-outs for England" @default.
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• W2111640356 date "2012-02-01" @default.
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• W2111640356 title "Ambulance call-outs and ‘disruptive technology’" @default.
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• W2111640356 doi "https://doi.org/10.12968/bjhc.2012.18.2.112" @default.
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