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Entries in health care (1)


Commentary on ”Reverse Innovation”

In his new book, reverse innovation 1, Vijay Govindarajan explores the hypothesis that innovations originating from low-income countries may provide solutions that can help in developed countries. A tail wagging the dog scenario that will likely rock the ivory tower of our western life science community. I think he is spot on.

Any time you apply constraints to innovation you come up with novel untried approaches to problems that may have not been attempted in a market without these limitations. This is classically demonstrated in 1st world health care delivery where profit is the motive because people have (had) the means to pay for good health care. As this paradigm shifts and we see 60 million Americans shut out from the US health care system (a global trend not just in the US), clearly, things must change.  

On the other end of the scale look at the low-income countries with enormous challenges in providing healthcare access to, not millions, but BILLIONS of people with a fraction of the resources and limited existing infrastructure to deliver this. If health care solutions must be approached within these constraints we need to think differently about how to approach this challenge.

When our team developed a new technology to quantify HIV viral load in patients as a way of monitoring drug effectiveness, we chose a marker that would allow the assay to be run in an environment with a reduced technology footprint, and at a lower total cost of delivery.  It also happened that this approach gave us added benefits not found in the existing technology developed for the first world.  Yes, it was a novel solution designed for heavily constrained environments AND it wound up being a better solution; it is capable of detecting all subtypes of HIV, not prone to contamination, does not require a clean room, and performs on par with the existing high-cost tests.  This technology makes HIV care more accessible to millions of patients in Africa, India, and Southeast Asia where the HIV disease burden is the highest.

Now, apply this technology to a rapidly deteriorating and under-funded HIV delivery system anywhere and you begin to see the benefits of constraint-based thinking. We see demand from New York, London and Frankfurt for our technology making it state of the art for a global health care reality; supply more care with fewer resources.

The theory of constraints is not new, Eli Glodrat wrote The Goal in 1984, where he introduced the concept of constraint analysis to optimize throughput. Isn’t that what we need more of in health care delivery today; more access (throughput) by eliminating delivery constraints? We applaud this insight from 1984 industry and welcome the Immelt and Govindarajan idea that "No longer will innovations traverse the globe in only one direction they will also flow in reverse." We believe in this shift and that technology will increasingly flow in both directions.

John Reisky de Dubnic





1 October 2009 HBR article "How GE Is Disrupting Itself" with GE's CEO Jeff Immelt pioneered the concept of reverse innovation