HBS heavy-hitters Clay Christensen and Michael Porter closed out a recent conference organized by HBS and Harvard Medical School. Held on the HBS campus November 14 and 15, "Healing Ourselves: Addressing Healthcare's Innovation Challenge" brought together some of the industry's top practitioners and leading thinkers to wrestle with the Gordian knot of healthcare reform.

The approach to reforming healthcare has been "hung up in static rather than dynamic thinking," said Christensen, who moderated a panel on "Improving the Patient Experience" with Andrew Sussman, president of MinuteClinic, and Tim Brown, president and CEO of the design firm IDEO. Christensen then drew a parallel between the evolution of the computer industry and what is slowly taking place in healthcare. Initially, people had to take their problems to the sites of large, mainframe computers (hospitals). The introduction of minicomputers created more of a midpoint (clinics) before desktop PCs became prevalent (home healthcare and services such as MinuteClinic). "We need to bring technology to outpatient clinics and patients' homes so they can provide more and more sophisticated care," said Christensen, who has written of his personal experience with the healthcare system.

Cue MinuteClinic, located in 640 CVS stores across 25 states. Staffed with nurse practitioners and physician assistants, it provides on-the-spot care for routine ailments such as strep throat and ear infections. "We are facing a profound shortage of primary care physicians," said Sussman. "We need to continue to broaden our thinking about the healthcare team to include nurse practitioners and pharmacists and allow them to practice at the top of their license."

"In the future, I expect the system is going to be quite overwhelmed," he added. "There are more uninsured people in Texas than the population of Massachusetts. How are we going to care for them?" MinuteClinic is obviously only part of the solution: "No one is going to get an appendectomy in the greeting card section," Sussman said. "Even routine conditions can be quite complex."

"As a designer, I see my job as navigating the interface between people and the world around us," said IDEO's Tim Brown. "Designers are good at simple and naïve ideas," he added. "Here's mine: Patients are people."

So what does that mean in the context of the healthcare system?

"Patients are consumers," Brown observed. "They have ever-rising expectations about the quality and clarity of their care." For that reason, Brown envisions a movement toward personally kept electronic records, a portable system that can be easily kept and brought by the patient from doctor to doctor. "The systems that give us the most delight put us in control," he observed.

Next week: Michael Porter's six-step plan for dramatically improving healthcare value, with insights from leadership at the Cleveland Clinic, Partners Healthcare, and the Henry Ford Health System.

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