Spotting key innovations in health

Jerry Fishenden is National Technology Officer for Microsoft in the UK. Jerry attended last week's NHS Confederation conference and delivered an inspiring session on technology and innovation before 250 healthcare CEOs.

Here, as part of his regular blog, Jerry shares his thoughts before and after the event.

18 June 2008

My head's whirling with all sorts of thoughts ahead of today's session at the NHS Confederation Conference in Manchester on "spotting key innovations". And with thoughts of innovation of course always comes thoughts of disruption, although it's rarely that technology itself is inherently disruptive so much as the new business models and strategies that technology enables (if only we're smart enough to spot and manage them in time).

Take a look for example at innovative multi-function devices, such as Media Centres or mobile phones, which bring together a whole host of different features in a single device. They're interesting examples of what has been termed "low-end disruption" in action.

In each of their individual functions they offer less than the fidelity or performance associated with the high end specialist devices available in the market (hence why a product such as Leicas M8 digital camera exists in the same market as mobile phones with digital cameras built-in and inexpensive consumer digital cameras).

Yet each successive generation of these converged devices improves. Witness for example the way that the cameras in mobile phones increase in resolution with each new model released. These multi-function devices are increasingly meeting the needs of many consumers and taking larger and larger market share.

These types of innovation illustrate the usual model we see operating in the marketplace: produce a low cost, "good enough" product, establish a foothold in the market and then seek to increase margins and growth by offering enhancements that will persuade increasing numbers of people to upgrade and replace earlier models. Digital cameras of course are a current disruptive innovation that have succeeded in largely replacing traditional film photography.

When I look at what could happen in health, there are many potential complex and interacting currents of innovation and disruption. And what might seem on the face of it a good thing (innovations that enable us all to live longer, better lives in our own homes and communities for example) can raise complex questions for policymakers, such as how to manage the impact of a larger, older population. And that's without the potential macro impacts of course of creating a world with an even larger overpopulation problem than currently predicted.

So where then will the next truly disruptive innovations come from? This is where my crystal ball shows many options, most of them a bit misty. After all, many innovations will emerge, show promise and then just as quickly fade away. There is after all a complex interplay here of not only technology and business strategies and models but also wider issues such as the prevailing economic and regulatory environment.

But some of my personal favourites floating around the crystal ball include advances in molecular nanotechnology, which could one day enable "printers" to "print" anything. We already see some basic 3D printers able to produce plastic prototypes right there in front of you.

Imagine what will become possible as they become more sophisticated. Could we really one day pay for new consumer items and then have them "printed" out in our home instead of manufactured and delivered in the current way? Will we also one day be able to "print" out our prescription medicines at home without even needing to go to the nearest pharmacy?

Then there are the cultural impacts of innovations in real-time language translation, enabling us to all communicate properly for the first time without the boundaries of language. What impact will such innovations have on the free movement of people and ideas around the world, a world in which the current constraints of language are a thing of the past?

Of course, such innovations place trust in the intermediating technology in the same way that we currently rely on human translators and get to know their own foibles. Let's hope technology doesn't end up doing the equivalent of that Hungarian phrase book that Monty Python used to feature, which turned perfectly ordinary tourist phrases in one language into lewd, suggestive comments in another. Perhaps such technology might even translate medical jargon into a language that patients can understand ...?

More fundamentally, genetic engineering shows enormous promise for tackling some of the most distressing and problematic issues of ill health and disease. It also has the potential to change almost everything about us, from appearance to behaviour. If the issues of population growth caused by us living longer, better lives are problematic for policymakers to get their heads around, this one is on an even bigger scale.
But enough idle crystal ball gazing for now or I'll forget where I'm headed.

I believe that personal health care and the move towards technological breakthroughs that enable us to self-medicate and manage our own health in our own homes and communities are already beginning to have an impact. Whilst our own aspirations and technology are increasingly aligned, policymaking often seems to be designed for the era that has just gone,with centrally mandated models and the idea of consolidation of infrastructure into physical locations that potentially run counter to the "new localisation" we are witnessing.

There does however seem to be an emergent consensus that health management needs to better reflect a citizen-centric approach. As technology is becoming pervasive, not just in secondary and primary health care but in our own homes, I believe the way healthcare is planned needs to change.

At the same time as we see great debate about the closure of many local hospitals and local facilities and a move to increasingly centralised services, technology is empowering a move in the precise opposite direction, a direction that politically is a better fit with the expectation and aspirations of citizens.

You only need to look at the way people are rejecting the current models of health planning to realise there is a serious disjoin somewhere between what people desire from their healthcare system (local, personalised services), what technology is making available (which broadly fits the localisation and personalisation of provision that people want) and the way in which policymaking has traditionally taken place. A better integration between policy planning and policy making and technology will enable a new generation of healthcare planning that better meets the needs of policymakers and citizens alike.

As I said at the beginning of this entry, it's rarely that technology itself is inherently disruptive so much as the new business models and strategies that technology enables (if only we're smart enough to spot and manage them in time).

So isn't it time we all got a bit smarter? And helped bring citizens, technologists, health professionals and healthcare planners and policymakers together in ways that would enable us to better understand and manage the implications of the disruptive innovations that are already upon us?

And, if we could achieve that, would this perhaps be the greatest practical innovation we could hope for in health?

19 June 2008

A good session on "Spotting Key Innovations" in health yesterday at the NHS Confederation Conference in Manchester. The theme of the event was "Delivering the future today". Not long after the Health Secretary Alan Johnson addressed the Conference from the auditorium, it was the turn of Paul Hodgkin, Chief Executive of Patient Opinion, and myself to take the floor, ably Chaired by Nigel Edwards.

I blogged yesterday many of my"run-up" thoughts to the event. Paul's insightful, patient-centric presentation and my own sparked a varied set of intelligent interactive questions and discussions in the large main auditorium not best suited to that purpose. And this was not just about the technology, but very much about people and processes too. And how we find levers of implementation, not just bright ideas in a vacuum.

The NHS Confederation released a timely and highly useful discussion paper, Disruptive Innovation, ahead of our session that I can recommend to anyone interested in the role of technology and innovation. Whilst obviously it's about health, it has far wider implications for us all.

And, at the end of a long day, it was good to get home and find a personal thank you letter from Steve Ballmer, our Chief Executive Officer, waiting for me. Microsoft remains a remarkably flat company in many ways and it set me to thinking about ways we can share other ideas about what makes organisations work effectively, not just about sharing ideas on technology.

Further Reading

- Review the NHS Confederation's Disruptive Innovation report

- Read Jerry Fishenden's full blog on issues of technology and policy, that you can also subscribe to via RSS

More about Jerry Fishenden

Jerry Fishenden is Microsoft UK's lead technology advisor, strategist and spokesman. Since being appointed to the role in 2005, Jerry has been responsible for helping to guide Microsoft's vision for how technology can transform the way we learn, live, work and play. He plays a key role in an international team of technology officers who work closely with Craig Mundie, Microsoft's Chief Research and Strategy Officer.

Prior to being recruited by Microsoft in 1997, Jerry worked in some of the UK's most senior IT positions including as Head of Business Systems for the UK’s chief financial services regulator in the City of London; as an Officer of the House of Commons, establishing the Parliamentary data and video Network at the Houses of Parliament; and as a Director of IT in the NHS.

As Microsoft UK's senior technology officer, Jerry works closely with key individuals and organisations across the UK, the media, analysts and professional associations, as well as with Microsoft product groups – to help ensure that Microsoft's vision, innovation and future technologies exceed expectations. He also regularly advises overseas governments and organisations on effective ways of using technology to enhance policy and services - and to accelerate innovation enabled by technology.