Looking For Hotbeds Of Health Care Innovation?

Look out your window.  WAY out your window, at emerging markets - Mexico, India, Rwanda.

Does your hospital have an indigent care "problem?"  Might it really be an opportunity in disguise, an opportunity to develop more creative ways of delivering health care to populations unable to afford your "edifice complex?"

Surely those models don't exist, do they?  Read on...

Consultants from McKinsey conducted research in partnership with the World Economic Forum to study the most promising novel forms of health care delivery and, in particular, to understand how these innovations changed health care's economics.

The takeaway: innovators—some from developing nations—have found ways to deliver care effectively at significantly lower costs while increasing access and quality.  Examples:

• "A Mexican telephone-based health advice and triage service available to more than one million subscribers for $5 per month, paid through phone bills.
• "In India, a new model of maternity care costing one-fifth of the price charged by the country's other private providers.
• "VisionSpring, an organization (bringing) affordable eye care to the poor in 13 countries, (succeeding) because it takes care givers close to patients through a low-cost franchise model. It teaches local “vision entrepreneurs”—members of the mainly poor communities they serve—how to diagnose problems such as presbyopia..."

Why are emerging markets such fertile ground for health care innovation?  McKinsey posits two reasons:

"Many of the most compelling innovations we studied come not from resource-rich developed countries but from emerging markets. Two factors help explain why. First, necessity breeds innovation; in the absence of adequate health care, existing providers and entrepreneurs must improvise and innovate. Second, because of weaknesses in the infrastructure, institutions, and resources of emerging markets, entrepreneurs face fewer constraints (this is one upside of the lack of meaningful oversight, which obviously also has many drawbacks). They can bypass Western models and forge new solutions."

There's the formula: Necessity breeding invention.  Removing constraints (or not allowing those you can't remove to slow you down.)  Forging new solutions while staying close to the customer.

Yeah, but that's India.  How do those inventions play in, say, Peoria?  I guess you won't know the answer until you ask the question.

GE Healthcare went to India with a 15-lb. electrocardiograph machine that cost $5.4 million and took three and a half years to develop and learned how to squeeze the same technology into a portable device that weighs less than three pounds and can be held with one hand.  And developed it in 18 months for just 60% of its wholesale cost.

More, here, about finding opportunities among difficulty, including a video from C.K. Prahalad about GE's development efforts.

And still more from The New York Times:

"(The country of) Rwanda has had national health insurance for 11 years now; 92 percent of the nation is covered, and the premiums are $2 a year.

"Sunny Ntayomba, an editorial writer for The New Times, a newspaper based in the capital, Kigali, is aware of the paradox: his nation, one of the world’s poorest, insures more of its citizens than the world’s richest does."

Depressingly, whenever another country's health system is offered as an example, someone shouts "Listen you pinko idiot!  If you think (insert country's name here) is so great, go LIVE THERE!  The good 'ol USofA has the best health care in the world!" 

Well, yes we do, especially if you're rich, critically ill and in need of super-sophisticated care.  Otherwise you pay your money (as much or maybe more than you can afford) and you take your chances.

And yet another idea from yours truly in April, 2009: "...it's like a food co-op except for health care."