School of Medicine, Stanford University, Stanford, CA, USA.
Ann Surg. 2011 Aug;254(2):203-8. doi: 10.1097/SLA.0b013e3182251538.
To build enabling innovation frameworks for health care entrepreneurs to better identify, evaluate, and pursue entrepreneurial opportunities.
Powerful frameworks have been developed to enable entrepreneurs and investors identify which opportunity areas are worth pursuing and which start-up ideas have the potential to succeed. These frameworks, however, have not been clearly defined and interpreted for innovations in health care. Having a better understanding of the process of innovation in health care allows physician entrepreneurs to innovate more successfully.
A review of academic literature was conducted. Concepts and frameworks related to technology innovation were analyzed. A new set of health care specific frameworks was developed. These frameworks were then applied to innovations in various health care subsectors.
Health care entrepreneurs would greatly benefit from distinguishing between incremental and disruptive innovations. The US regulatory and reimbursement systems favor incrementalism with a greater chance of success for established players. Small companies and individual groups, however, are more likely to thrive if they adopt a disruptive strategy. Disruption in health care occurs through various mechanisms as detailed in this article. While the main mechanism of disruption might vary across different health care subsectors, it is shown that disruptive innovations consistently require a component of contrarian interpretation to guarantee considerable payoff.
If health care entrepreneurs choose to adopt an incrementalist approach, they need to build the risk of disruption into their models and also ascertain that they have a very strong intellectual property (IP) position to weather competition from established players. On the contrary, if they choose to pursue disruption in the market, albeit the competition will be less severe, they need to recognize that the regulatory and reimbursement hurdles are going to be very high. Thus, they would benefit from seeking market opportunities that are large enough to warrant greater regulatory and reimbursement risks.
为医疗保健企业家构建有利的创新框架，以更好地识别、评估和追求创业机会。
已经开发出强大的框架，使企业家和投资者能够识别哪些机会领域值得追求，以及哪些创业理念有可能成功。然而，这些框架尚未针对医疗保健创新进行明确和解释。更好地了解医疗保健创新的过程可以使医生企业家更成功地创新。
对学术文献进行了回顾。分析了与技术创新相关的概念和框架。开发了一套新的医疗保健特定框架。然后将这些框架应用于各个医疗保健子行业的创新。
医疗保健企业家将从区分增量创新和颠覆式创新中受益匪浅。美国的监管和报销系统倾向于渐进式创新，为现有参与者带来更大的成功机会。然而，小公司和个别团体如果采用颠覆性策略，更有可能茁壮成长。如本文所述，医疗保健领域的颠覆通过各种机制发生。虽然不同医疗保健子行业的主要颠覆机制可能有所不同，但可以看出，颠覆性创新始终需要一定程度的反向解释，以保证可观的回报。
如果医疗保健企业家选择采用渐进式方法，他们需要将颠覆风险纳入其模型，并确保他们拥有非常强大的知识产权（IP）地位，以抵御来自现有参与者的竞争。相反，如果他们选择在市场上追求颠覆，尽管竞争将不那么激烈，他们需要认识到监管和报销的障碍将非常高。因此，他们将受益于寻求足够大的市场机会，以证明更大的监管和报销风险是合理的。
