Tag Archives: disruptive innovation

Healthcare innovation

m2graphicThis link (via Gayle D.) is pure awesome. Turns out someone has decided to offer prescription drugs via an ATM. For policy wonks, this has all the hallmarks of a disruptive innovation.

I suspect that in the pharmaceutical industry the 80/20 rule is in effect. That being 80% of  patients are using only 20% of the available drugs. So a small number of drugs account for the vast majority of all prescriptions filled. That means you could service a huge part of the market with only a handful of drugs on hand.

This is precisely what this ATM for drugs allows you to do. Moreover, it allows you to do it faster, cheaper and with a better experience for customers. That is precisely what a disruptive innovation is.

Indeed, you can see the early signs of its disruptive nature in the way it is being talked about.

The Canadian Pharmacists’ Association has endorsed the machine, but it appears oblivious to the machine’s implications (despite the very clear case study of the decline of bank tellers after the introduction of ATMs – although perhaps the idea of pharmacists comparing themselves to bank tellers is so threatening that they ignored that data):

Some pharmacists will undoubtedly feel threatened by the technology, says Jeff Poston, executive director of the Canadian Pharmacists’ Association.

But he predicts the machines will have only a niche role, likely in remote communities that have limited pharmacy services, since the devices offer patients a “lesser” form of communication with the druggist.

“I tend to think the face-to-face encounter with the pharmacist would win hands down,” he said.

Niche role? I suppose, if you count 80% of the pharmacy business as niche. I suspect this service will take off – and we’ll need fewer pharmacists. On the flip side, the pharmacists we keep will have to very good since they’ll be focused on the more dangerous, complicated and difficult prescriptions – which really is the best use of their time.

What about people’s alleged preference for face-to-face encounters? Perhaps this is a preference. But how strong is that preference? For me, it isn’t so strong that I’m willing to hang around in the pharmacy for 30 minutes while my prescription is being filled, or worse, to come back they next day. I suspect that the overwhelming majority of us will use the ATMs – just like we do at the bank.

Indeed, the president of the company that creates the ATMs for drugs – who is quoted later in the article – knows what’s really going on:

Just over 800 patients used the machines at Sunnybrook to obtain 1,200 prescriptions between June and September. A survey of 108 of them indicated that more than 95% received their drug in less than five minutes and would use PharmaTrust again, said Peter Suma, president of PCA. None of the prescriptions was incorrectly filled, he said.

Not everyone, however, was able to take advantage of the pharmaceutical ATMs. About a third of patients who tried discovered that their medicine was not available, said Dr. Domb, though PCA offers to deliver those orders to the patient’s home the next day.

Despite such limitations, Mr. Suma predicts his kiosks will be embraced by consumers accustomed to instant, technologically aided service, especially when the devices are “deployed ubiquitously.”

95% satisfaction rate? This technology is killer. And check out the different perspectives of the two quotes.

On the one hand, the industry expert and entrenched actor (the pharmacists association executive director) believes the ATMs will be restricted to a niche market (such as rural markets). In contrast, the disruptor (the president of PCA) sees these machines as being “deployed ubiquitously.”

They can’t both be right.

Microsoft: A case study in mismanaging a business ecosystem

mslogoA lot of fuss has been made about Microsoft’s inability to compete in the online space and the web specifically.  Indeed, it is widely acknowledged that Microsoft was slow to understand the web’s implications and adjust its product lines accordingly. How did the largest, most successful software company in the world fail to predict or even, once the future became clear, effectively adapt to the rise of the internet? More importantly, why hasn’t it been able to acquire its way out of trouble?

Numerous articles have been written on this, many focusing on Microsoft’s strategy and the fact that it likely faced a disruptive innovation problem. I’d like to supplement that analysis by focusing on the predatorial way Microsoft managed and engaged its business ecosystem in the 1990s. I’ve not seen this analysis before so I thought I would throw it out there.

The 1990’s were a good time for Microsoft. It experienced tremendous growth and its operating system was by far the dominant choice in the market place. It had tremendous leverage over everyone in its business ecosystem, including its competitors, customers and complementors. While this was seen as a source of strength (and profit) it also laid the foundation for many of its problems. The story of Microsoft’s competitors in its traditional marketplace – especially those that have adopted an open source space model such as Linux, Mozilla and Apache – is well documented and forms the core of the traditional disruptive innovation thesis. But I think Microsoft’s inability to counter these threats, as well as its inability to compete in new spaces – such as against Yahoo! or Google – isn’t just a result of the fact that it crushed its traditional competitors but also due to the mismanagement of its relationship with its complementors and partners. More importantly, the disruptive innovation thesis fails, on its own, to explain why Microsoft hasn’t been able to acquire itself out of its problems.

I’ve been told that one of Microsoft’s great strengths is that it has fantastic tools for developers (I’m not a coder so I can’t comment myself). However, in the 1990s and early 2000s, Microsoft lacked a sophisticated or long-term strategy for engaging the software products and companies those developers created. Given that Microsoft was sitting atop the  computer software ecosystem the company had one goal – staying there. This lead it to view anyone as a potential competitor – or if not a competitor than at least someone eating into profits that it could otherwise capture. Rather than balancing the growth of the value network with trying to capture its fair share, Microsoft prioritized the latter over the former. Consequently, many companies that produced products within the Microsoft ecosystem – particularly for Windows – were often not seen as complementors, but as rivals. Microsoft was aggressive in dealing with them – it was gracious in that it would usually offer to buy them out – on its terms – but always looming in the background was the threat that if you didn’t sell to them they would copy what you did. Consequently, many little companies that designed applications that enhanced Windows were forced to sell – or were put out of business after Microsoft copied their products and integrated them into the operating system.

A business ecosystem is like a natural one. It doesn’t matter how nutrient rich the environment (like say, one with excellent development tools) if emerging lifeforms are consistently snuffed out, pretty soon they will elect to grow and evolve elsewhere – even in places where the nutrients are weaker. This is precisely what I suspect started to happen. Likely, fewer and fewer developers wanted to approach the Microsoft ecosystem with a 10-foot pole because they would either be bought out on unfavorable terms or at an early stage (before they were too valuable) or worse, Mircosoft would simply crush them by using its enormous resources to replicate them and eat into their business.

The repercussion of this is that Microsoft saw fewer and fewer new and innovative products being created for its platforms. Programmers and developers shifted to other platforms, or created whole new platforms where they would be free to grow ideas. This, I believe, prevented Microsoft from understanding how the web would change its business. Not only did its current profits create a disincentive to altering its business strategy but it snuffed out one of the few groups of people that could warn it, educate it and challenge it, about the impending changes – its complementors and partners. Equally important is that it diminished the pool of potential acquisition targets whose culture, technology and processes might have helped Microsoft adapt. There were simply not that many mid-sized mammals in the ecosystem: Microsoft had prevented them from evolving.

Today – based on conversations I’ve had with some people in Microsoft – I get the sense that they are trying to become a better partner (or at at least, they may be aware of the problem). Perhaps Microsoft will succeed in becoming a better partner. It won’t however, be easy. Changes to how one treats complementors and partners often require rethinking the very culture of an organization. This is never an easy or quick process. In addition, it takes time to rebuild trust and attract new blood into the ecosystem… and any misstep will count dearly against you.

There are also almost certainly some interesting lessons in this for other dominant players – such as Google. Will Google behave differently? I don’t know. In many regards Microsoft behaviour was rational. It was seeking to preserve its position and maximize its share of the pie. This was made all the tougher because its market was evolving and the future was unclear. No one knew which pieces of the value network would be critical (and therefor most profitable)  and so Microsoft was simply trying to stake out as many of them as possible. It is easy to imagine Google behaving in a similar manner. But I suspect that if it does, it may also find it hard to escape Microsoft’s fate.

Big thank you to David H. for pointing out some typos and errors.