The Innovator’s Dilemma: Will Patient Safety Solutions Come from Current or New Technologies?

Updated: Sep 12

By Paul Gallese, PT, MBA

The Innovator’s Dilemma” by Clayton Christensen (1997) is a book familiar to many in the technology industry, as well as I’m sure to quite a few health care professionals reading this blog post. Among other things, the book discusses how new, disruptive technologies gain a foothold in markets by meeting customers’ unstated or future needs.

In a nutshell, commonly used technologies sustain themselves by meeting customers’ current needs while disruptive technologies find ways to solve problems customers don’t even realize they have.

For example, electronic medical record (EMR) systems are a current technology deployed in health care organizations to make medical care better, safer and more cost efficient. EMRs meet customers’ needs by recording important patient medical history information needed for care decisions and billing.

EMRs are often criticized, however, because they can interrupt workflow and draw the attention of caregivers away from patients. Studies have documented that both doctors and nurses spend more time interacting with technology than with patients (Higgens, 2017; Tai-Seale, 2017).

Health care leaders look to established vendors for innovation, but it often comes from elsewhere

To improve workflow and patient-provider engagement, health care leaders often look to EMR vendors for innovation. In an effort to fulfill their customers’ needs, EMR vendors refine their products or offer add-ons purporting to solve these challenges. Other established vendors marketing within the hospital space, such as bed vendors, also attempt to sell add-ons, such as patient-monitoring capabilities, to their basic services.

But according to “The Innovator’s Dilemma,” true innovation rarely comes from incumbent technology vendors that are working to sustain their products and revenue streams. In other words, innovative solutions to your patient safety, workflow, patient engagement, and other challenges will most likely not come from your EMR or your beds vendor. The solutions will come from new, disruptive technologies that will solve problems you don’t realize you have. As Henry Ford once reportedly said, “If I had asked people what they wanted, they would have said faster horses.”

In an Assent blog post about “The Innovator’s Dilemma,” Matt Whitteker captures a common dynamic well. “(Incumbents) increase spending on features / performance / functionality, all with longer times to ship because they are big and clunky. They gather with their cadre of high-requirement customers and have planning sessions about how they can make even more high-performing products. All the while the new entrant is usually innovating faster because of leaner infrastructure and a more focused product.”

To improve patient safety, health care leaders must innovate workflow to make patient-caregiver interactions more effective

The Vitalacy team is obsessed with understanding the most important moments in health care -- the face-to-face moments when patients and caregivers interact -- and making this time more effective. The communications that occur during these interactions have the greatest bearing on the quality, safety and effectiveness of health care. These are the moments that prevent infections, falls, pressure ulcers, venous thromboembolism (VTE) and other common healthcare-acquired conditions.

To make these moments the best they can be, health care organizations must understand workflow, and then how to adjust and improve it to make patient-caregiver interactions more effective. These improvements can achieve better patient safety and clinical outcomes.

The Vitalacy Patient Safety Platform works by linking each care provider to data-gathering sensors positioned throughout the unit. By the use of a simple, Bluetooth-enabled wristband or name badge tag worn by each care provider, the sensors track the care provider’s movements and locations throughout the shift. By gathering these movement and location data, unit managers can gain a true understanding of present workflow and gain the necessary insights to improve the effectiveness of rounding activities and hand hygiene compliance while preventing nurse fatigue and the errors and turnover associated with it.

Ultimately, everything hinges on the effectiveness of workflow

The sustainability of every health care organization will depend entirely on its ability to maximize the effectiveness of its workforce, and this depends on maximizing the effectiveness of workflow.

These are the questions health care leaders who consider themselves innovators must ask:

● How can I measure the effectiveness of workflow, from the perspective of the patient?

● What kinds of innovations to my workflow are necessary to make patient-caregiver interactions more frequent and more effective?

● How do I measure the impact of more effective patient-caregiver interactions on patient safety?

Rather than retrofitting incumbent technology to solve a problem it wasn’t meant to solve, leaders must deploy technology specifically created to achieve patient safety. Vitalacy’s technology provides data that enables your care providers to work more effectively. It’s a new, disruptive technology that improves the interactions between patients and your care providers, a challenge you didn’t know you had until now. Making the moments they spend together more effective is the key to patient safety.

I will be talking about this topic at length during a Sept. 25, 2019, webinar: “How to Deploy Disruptive Technology in Healthcare Organizations.” Register here.


Christensen, C.M. The Innovator’s Dilemma: When New Technologies Cause Great Firms to Fail. Harvard Business Review Press; 1st edition (May 1, 1997).

Higgens, L, et al. Hospital nurses’ activity in a technology-rich environment. Journal of Nursing Care Quality, July/Sept. 2017, 32(3):208-217.

Tai-Seale, M, et al. Electronic medical record logs indicate that physicians split time evently between seeing patients and desktop medicine. Health Affairs, April 2017, 36(4).

Whitteker, M. The Innovator’s Dilemma and selecting a compliance vendor. Assent Blog. Feb. 19, 2014.

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