Shift Left

Mr. Grove says he is alarmed by several structural issues involving health care in America, notably, the huge number of uninsured, who are often forced to get primary care in emergency rooms.

To explain "Shift left," Mr. Grove describes the bottom axis of a scale in which products and services grow more full-featured, complicated and expensive as you move to the right. To "Shift left" on this scale is to, in effect, "Keep it simple, stupid."

Specifically, Mr. Grove is a big fan of low-cost, walk-in clinics, the sort beginning to appear in stores like Wal-Mart. He says they provide basic medical care for the uninsured, and also take some strain off of America's overloaded emergency rooms. But one thing missing from this emerging clinic infrastructure is a good system of medical record-keeping.

Mr. Grove, naturally, thinks technology can help. But rather than designing an elaborate and technically sophisticated medical-database system, something virtually every tech company is now trying to do, Mr. Grove suggests the exact opposite. Shift left; keep the record of a patient's visit in, for example, a generic but Web-accessible word-processing file.

Just like the early PC, it will be far from ideal, but it will be a start, and it can get better over time. The alternative, he says, is to wait endlessly for a perfect technology.

Students of business history will recognize the idea of a plain-vanilla medical record as an example of a "disruptive technology," which is initially opposed by powerful incumbents with a vested economic interest in shifting ever-rightward. So which powerful incumbents might oppose him now?

Read the full article on the post-gazette.com