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Disruptive technologies in health care disenchanted: a systematic review of concepts and examples

Published online by Cambridge University Press:  16 May 2022

Matthias Perleth Open the ORCID record for Matthias Perleth [Opens in a new window] ,
Rossella Di Bidino Open the ORCID record for Rossella Di Bidino [Opens in a new window] ,
Li-Ying Huang Open the ORCID record for Li-Ying Huang [Opens in a new window] ,
Lydia Jones Open the ORCID record for Lydia Jones [Opens in a new window] ,
Michelle Mujoomdar ,
Susan Myles ,
Andres Pichon-Riviere Open the ORCID record for Andres Pichon-Riviere [Opens in a new window] ,
Junainah Sabirin ,
Tara Schuller Open the ORCID record for Tara Schuller [Opens in a new window]  and
Jennifer Washington
Matthias Perleth*
Affiliation:
Abteilung Fachberatung Medizin, Gemeinsamer Bundesausschuss (G-BA), Berlin, Germany
Rossella Di Bidino
Affiliation:
Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Directorate for Technology and Innovation, Health Technology Assessment Unit, Rome, Italy
Li-Ying Huang
Affiliation:
Division of Health Technology Assessment, Center for Drug Evaluation, Taipei, Taiwan
Lydia Jones
Affiliation:
Abteilung Fachberatung Medizin, Gemeinsamer Bundesausschuss (G-BA), Berlin, Germany
Michelle Mujoomdar
Affiliation:
Scientific Affairs, Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa, ON, Canada
Susan Myles
Affiliation:
Health Technology Wales, Cardiff, United Kingdom
Andres Pichon-Riviere
Affiliation:
Health Technology Assessment and Health Economics Department, Institute for Clinical Effectiveness and Health Policy, University of Buenos Aires, Buenos Aires, Argentina
Junainah Sabirin
Affiliation:
Malaysian Health Technology Assessment Section (MaHTAS), Medical Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
Tara Schuller
Affiliation:
International Network of Agencies for Health Technology Assessment (INAHTA) Secretariat, Edmonton, AB, Canada
Jennifer Washington
Affiliation:
Health Technology Wales, Cardiff, United Kingdom
*
*Author for correspondence: Matthias Perleth, E-mail: matthias.perleth@g-ba.de
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Abstract

Objectives

To clarify the concept of disruptive technologies in health care, provide examples and consider implications of potentially disruptive technologies for health technology assessment (HTA).

Methods

We conducted a systematic review of conceptual and empirical papers on healthcare technologies that are described as “disruptive.” We searched MEDLINE and Embase from 2013 to April 2019 (updated in December 2021). Data extraction was done in duplicate by pairs of reviewers utilizing a data extraction form. A qualitative data analysis was undertaken based on an analytic framework for analysis of the concept and examples. Key arguments and a number of potential predictors of disruptive technologies were derived and implications for HTA organizations were discussed.

Results

Of 4,107 records, 28 were included in the review. Most of the papers included conceptual discussions and business models for disruptive technologies; only few papers presented empirical evidence. The majority of the evidence is related to the US healthcare system. Key arguments for describing a technology as disruptive include improvement of outcomes for patients, improved access to health care, reduction of costs and better affordability, shift in responsibilities between providers, and change in the organization of health care. A number of possible predictors for disruption were identified to distinguish these from “sustaining” innovations.

Conclusions

Since truly disruptive technologies could radically change technology uptake and may modify provision of care patterns or treatment paths, they require a thorough evaluation of the consequences of using these technologies, including economic and organizational impact assessment and careful monitoring.

Keywords

Technology assessmentBiomedicalDisruptive technologySystematic reviewHealth care marketsDiffusionInnovation
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 38 , Issue 1 , 2022 , e70
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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Footnotes

We are grateful for the peer review of the search strategy by the information specialists of the Team Information Management of the G-BA.

References

O’Rourke, B, Werko, SS, Merlin, T, Huang, LY, Schuller, T (2020) The ‘Top 10′ challenges for health technology assessment: INAHTA viewpoint. Int J Technol Assess Health Care. 36(1), 1–4. https://doi.org/10.1017/S0266462319000825.CrossRefGoogle ScholarPubMed
Olberg, B, Perleth, M, Busse, R (2014) The new regulation to investigate potentially beneficial diagnostic and therapeutic methods in Germany: Up to international standard? Health Policy. 117(2), 135–145. https://doi.org/10.1016/j.healthpol.2014.04.018.CrossRefGoogle ScholarPubMed
Christensen, CM, Raynor, ME, McDonald, R (2015) What is disruptive innovation? Harvard Bus Rev. 93(12), 44–53. https://hbr.org/2015/12/what-is-disruptive-innovation.Google Scholar
Bower, JL, Christensen, CM (1995) Disruptive technologies: Catching the wave. Harvard Bus Rev. 73(1), 43–53. https://hbr.org/1995/01/disruptive-technologies-catching-the-wave.Google Scholar
Christensen, CM, Bohmer, R, Kenagy, J (2000) Will disruptive innovations cure health care? Harvard Bus Rev. 78(5), 102–112. https://hbr.org/2000/09/will-disruptive-innovations-cure-health-care.Google ScholarPubMed
Hwang, J, Christensen, CM (2008) Disruptive innovation in health care delivery: A framework for business-model innovation. Health Aff (Millwood). 27(5), 1329–1335. https://doi.org/10.1377/hlthaff.27.5.1329.CrossRefGoogle ScholarPubMed
Smith, RS (2013) Disruptive technology in the treatment of thoracic trauma. Am J Surg. 206(6), 826–833. https://doi.org/10.1016/j.amjsurg.2013.10.004.CrossRefGoogle ScholarPubMed
Chan, S (2006) Strategy development for anticipating and handling a disruptive technology. J Am College Radiol. 3(10), 778–786. https://doi.org/10.1016/j.jacr.2006.03.014.CrossRefGoogle ScholarPubMed
Grady, J (2014) Telehealth: A case study in disruptive innovation. Am J Nurs. 114(4), 38–45. https://doi.org/10.1097/01.NAJ.0000445682.52553.89.CrossRefGoogle ScholarPubMed
Kaslow, DC (2004) A potential disruptive technology in vaccine development: Gene-based vaccines and their application to infectious diseases. Trans R Soc Trop Med Hyg. 98(10), 593–601. https://doi.org/10.1016/j.trstmh.2004.03.007.CrossRefGoogle ScholarPubMed
Nam, SH (2015) Why disruptive innovations matter in laboratory diagnostics. Clin Chem. 61(7), 935–937. https://doi.org/10.1373/clinchem.2014.235358.CrossRefGoogle ScholarPubMed
Rifai, N, Topol, E, Chan, E, Lo, YM, Wittwer, CT (2015) Disruptive innovation in laboratory medicine. Clin Chem. 61(9), 1129–1132. https://doi.org/10.1373/clinchem.2015.243667.CrossRefGoogle ScholarPubMed
Saffitz, JE (2012) Genomic pathology: A disruptive innovation. Per Med. 9(3), 237–239. https://doi.org/10.2217/pme.12.5.CrossRefGoogle ScholarPubMed
Schwamm, LH (2018) Disruptive innovation in acute stroke systems of care. Lancet Neurol. 17(7):576–578. https://doi.org/10.1016/S1474-4422(18)30197-2.CrossRefGoogle ScholarPubMed
Jonsson, B (2017) Disruptive innovation and EU health policy. Eur J Health Econ. 18(3), 269–272. https://doi.org/10.1007/s10198-016-0840-z.CrossRefGoogle ScholarPubMed
Schulman, KA, Vidal, AV, Ackerly, DC (2009) Personalized medicine and disruptive innovation: Implications for technology assessment. Genet Med. 11(8), 577–581. https://doi.org/10.1097/GIM.0b013e3181ae0935.CrossRefGoogle ScholarPubMed
Banda, G, Tait, J, Mittra, J (2018) Evolution of business models in regenerative medicine: Effects of a disruptive innovation on the innovation ecosystem. Clin Ther. 40(7):1084–1094. https://doi.org/10.1016/j.clinthera.2018.06.003.CrossRefGoogle ScholarPubMed
Eltoum, IA, Alston, EA, Roberson, J (2012) Trends in pancreatic pathology practice before and after implementation of endoscopic ultrasound-guided fine-needle aspiration: An example of disruptive innovation effect? Arch Pathol Lab Med. 136(4), 447–453. https://doi.org/10.5858/arpa.2011-0218-OA.CrossRefGoogle ScholarPubMed
Kornowski, R (2017) Is transcatheter aortic valve replacement taking the path of disruptive innovation technology? Struct Heart. 1(3–4), 138–142. http://doi.org/10.1080/24748706.2017.1362135.CrossRefGoogle Scholar
Li, J, Westbrook, J, Callen, J, Georgiou, A (2012) The role of ICT in supporting disruptive innovation: A multi-site qualitative study of nurse practitioners in emergency departments. BMC Med Inform Decis Mak. 12, 27. https://doi.org/10.1186/1472-6947-12-27.CrossRefGoogle ScholarPubMed
Niranjan, A, Madhavan, R, Gerszten, PC, Lunsford, LD (2012) Intracranial radiosurgery: an effective and disruptive innovation in neurosurgery. Stereotact Funct Neurosurg. 90(1), 1–7. https://doi.org/10.1159/000334673.CrossRefGoogle ScholarPubMed
Glabman, M (2009) Disruptive innovations that will change your life in health care. Manag Care. 18(1):12–16, 19-21Google ScholarPubMed
McKinlay, JB, Marceau, LD (2012) From cottage industry to a dominant mode of primary care: Stages in the diffusion of a health care innovation (retail clinics). Soc Sci Med. 75(6):1134–1141. https://doi.org/10.1016/j.socscimed.2012.04.039.CrossRefGoogle Scholar
Paterick, ZR, Pradhan, SR, Paterick, TE, Waterhouse, BE (2009) Changing perspectives in medical practice: Disruptive innovation. J Med Pract Manage. 24(5), 290–292.Google ScholarPubMed
Havighurst, CC (2008) Disruptive innovation: The demand side. Health Aff (Millwood). 27(5), 1341–1344. https://doi.org/10.1377/hlthaff.27.5.1341.CrossRefGoogle ScholarPubMed
Pauly, MV (2008) ‘We aren’t quite as good, but we sure are cheap’: Prospects for disruptive innovation in medical care and insurance markets. Health Aff (Millwood). 27(5), 1349–1352. https://doi.org/10.1377/hlthaff.27.5.1349.CrossRefGoogle ScholarPubMed
Friedberg, RD, Nakamura, BJ, Winkelspect, C, Tebben, E, Miller, A, Beidas, RS (2018) Disruptive innovations to facilitate better dissemination and delivery of evidence-based practices: Leaping over the tar pit. Evidence-Based Pract Child Adolesc Mental Health. 3(2), 57–69. https://doi.org/10.1080/23794925.2018.1427009.CrossRefGoogle Scholar
Rosenwasser, RH, Lang, M, Tjoumakaris, S, Jabbour, P (2017) Disruptive innovation in neurovascular disease. Neurosurgery. 64(1), 78–82. https://doi.org/10.1093/neuros/nyx335.CrossRefGoogle ScholarPubMed
Sterling, R, LeRouge, C (2019) On-demand telemedicine as a disruptive health technology: Qualitative study exploring emerging business models and strategies among early adopter organizations in the United States. J Med Internet Res. 21(11), e14304. https://doi.org/10.2196/14304.CrossRefGoogle ScholarPubMed
Sounderajah, V, Patel, V, Varatharajan, L, et al. (2021) Are disruptive innovations recognised in the healthcare literature? A systematic review. BMJ Innov. 7(1), 208–216. https://doi.org/10.1136/bmjinnov-2020-000424.CrossRefGoogle ScholarPubMed
Expert Panel on Effective Ways of Investing in Health. Disruptive innovation: considerations for health and health care in Europe. Brussels: European Union; 2016. Available from https://ec.europa.eu/health/sites/default/files/expert_panel/docs/012_disruptive_innovation_en.pdf.Google Scholar
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