Sustaining Innovations and Disruptive Technologies: Implications
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SUSTAINING INNOVATIONS AND DISRUPTIVE TECHNOLOGIES: IMPLICATIONS FOR MOBILE HEALTH (MHEALTH) CARE PLATFORMS by Jerry Mitchell Robinson APPROVED BY SUPERVISORY COMMITTEE: ___________________________________________ Anne Balsamo, Chair ___________________________________________ Frank Dufour ___________________________________________ Todd Fechter ___________________________________________ Midori Kitagawa Copyright 2017 Jerry Mitchell Robinson All Rights Reserved Thanks to my wife, Lora Lea Robinson, for her incredible patience and confidence in my vision. Thanks also to Dr. Frank Dufour for his leadership, wisdom, and incredible patience. Thank you, Dr. M. Phillips, for amazing expertise in the art of the dissertation and for being my patient sounding board and encouraging coach. SUSTAINING INNOVATIONS AND DISRUPTIVE TECHNOLOGIES: IMPLICATIONS FOR MOBILE HEALTH (mHEALTH) CARE PLATFORMS by JERRY MITCHELL ROBINSON, BS, MA DISSERTATION Presented to the Faculty of The University of Texas at Dallas in Partial Fulfillment of the Requirements for the Degree of DOCTOR OF PHILOSOPHY IN ARTS, TECHNOLOGY, AND EMERGING COMMUNICATION THE UNIVERSITY OF TEXAS AT DALLAS December 2017 ACKNOWLEDGMENTS Thanks to my committee members: Todd Fechter, Dr. Midori Kitagawa, Dr. Anne Balsamo, and Dr. Frank Dufour for your support, inspiration, and guidance. August 2017 v SUSTAINING INNOVATIONS AND DISRUPTIVE TECHNOLOGIES: IMPLICATIONS FOR MOBILE HEALTH (mHEALTH) CARE PLATFORMS Jerry Mitchell Robinson, PhD The University of Texas at Dallas, 2017 ABSTRACT Supervising Professor: Anne Balsamo, PhD mHealth technology is at the dawn of its effect on humanity and global health. Just as the cell phone rapidly morphed from a sustaining local innovation to a global disruptive innovation, mHealth technology and ecosystems will rapidly morph and expand beyond their original scope. This paper proposes a limited, predictive analytic method approach to consider mHealth elements. Based on deconstructionist theories of Foucault, affordance theories of Gibson, forecasting theories of Tetlock, and a simple Fermi Estimation prediction model, a simple predictive model for comparing mHealth elements in an IoT wireless ecosystem is presented. The necessity for frictionally more cost-effective health care solutions is one that mHealth technology can effectively address. Improved forecast methodology assists in selecting the “most right” mHealth specific methods and technologies to develop and pursue. vi TABLE OF CONTENTS ACKNOWLEDGMENTS …...………………………………………………………….....…… v ABSTRACT ……………………………………………………………………………………. vi LIST OF FIGURES ……………………………………………………………………………. ix LIST OF TABLES ……………………………………………………………………………... x CHAPTER 1 INTRODUCTION: SUSTAINED INNOVATION AND THE IMPLICATION FOR DISRUPTIVE INNOVATION IN mHEALTH CARE DELIVERY .................................... 1 CHAPTER 2 DEFINING THE NEED FOR DISRUPTION INNOVATION WITHIN THE HEALTH CARE INDUSTRY ........................................................................................................ 9 CHAPTER 3 A FRAMEWORK FOR EXAMINING AND PREDICTING DISRUPTIVE INNOVATION IN HEALTH CARE DELIVERY ...................................................................... 25 Profit 29 Cash 30 Ubiquity of Mobile Networks 31 Global Need for Healthcare Provision 32 Infrastructure of the Mobile Communications Ecosystem 33 End User Practices 34 Rising Health Care Costs 35 US Legislation at Both State and Federal Levels 36 Global Translational Alliances 38 Infrastructure of the Health Care Industry 39 Finance, Funding, and Capital Trends 40 Rate of Growth for Smartphone Applications 43 vii Recent Smartphone Growth from Top Vendors 45 Recent Smartphone Operating System (OS) Growth 46 Recent Smartphone Apps Growth 47 New Smartphone Linked Device Growth 51 Rate of Growth for mHealth Applications 52 Evaluation of Affordances 54 CHAPTER 4 KALMAN VALUATION FOR A COMPOSITE ANALYIS IN mHEALTH FORECASTING ........................................................................................................................... 57 A Retrospective on Early Wireless Affordances 58 Accuracy of Experts: Understanding the Importance of Forecasting 62 Device-Level Forecasting within the Mobile Communications Ecosystem: The Automated External Defibrillator (AED) Example 68 Forecasting Overall mHealth Growth in the Mobile Communications Ecosystem 70 CHAPTER 5 PREDICTIVE MODELS FOR TECHNOLOGICAL GROWTH: IMPLICATIONS FOR FURTHER RESEARCH ........................................................................ 76 BIBLIOGRAPHY ......................................................................................................................... 85 BIOGRAPHICAL SKETCH ........................................................................................................ 97 CURRICULUM VITAE ............................................................................................................... 98 viii LIST OF FIGURES Figure 1. Mobile cellular subscriptions (per 100 people). Source: 2016 ITU ...............................19 Figure 2. Smartphone Ecosystem Organization .............................................................................44 ix LIST OF TABLES Table 1. Top Global Pharma and Device Makers with offshore Cash ..........................................41 Table 2. Current Top Five Smartphone Vendors and Y-Y Growth – April 2017 .........................46 Table 3. Smartphone Ecosystem Operating Systems and Market Share 2017 ..............................47 Table 4. Apple iOS App Store Sales and Downloads Through June of 2015 ...............................48 Table 5. Google Play App Sales by Date to 2016 ..........................................................................50 Table 6. Evaluation of Affordances Upon mHealth Applications and Devices ............................55 Table 7. Formula for Calculation of Affordances Upon the Mobile Communications Ecosystem for mHealth Applications and Devices ..............................................................................71 Table 8. Rationale for Binary Values for Each Affordance ...........................................................73 Table 9. Rationale for Static Values for Each Affordance ............................................................73 Table 10. Rationale for Static Temporal Values for Each Affordance ..........................................74 x CHAPTER 1 INTRODUCTION: SUSTAINED INNOVATION AND THE IMPLICATION FOR DISRUPTIVE INNOVATION IN mHEALTH CARE DELIVERY The breakthrough innovations come when the tension is greatest and the resources are most limited. That's when people are actually a lot more open to rethinking the fundamental way they do business. Clayton Christensen This chapter discusses how disruptive technology evolves in opposition to sustaining innovation and the implications of this phenomenon for solving the global challenge of health care delivery. A key thread of this study is an appraisal of how a sustaining innovation, the mobile telephone, morphed into a globally-disruptive innovation that was not anticipated, even by acknowledged industry experts.1 We recently passed the cell phone's 43rd anniversary milestone. With almost 7 billion active cell phone subscriptions,2 most of the planet’s 7.4 billion people3 have access to mobile communications technology. Profound, sweeping political and economic changes have resulted worldwide from the impact of low cost/low frictional use of wireless communications. 1 Clayton M. Christensen, The Innovator's Dilemma: The Revolutionary Book That Will Change the Way You Do Business (New York: Collins Business Essentials, 2005). 2 Brahima Sanou, “The World in 2014: ICT Facts Figures” (International Telecommunication Union, April 2014). 3 “2014 World Population Data Sheet - 2014-World-Population-Data-Sheet_eng.Pdf,” n.d., 3, accessed October 29, 2014, http://www.prb.org/pdf14/2014-world-population-data-sheet_eng.pdf. 1 While at Motorola, Dr. Martin Cooper4 made the first cellphone call on April 3, 1973. Cooper led a Motorola development team in inventing the practical cell phone. He is the primary invention patent holder5 and widely considered6 to be the "father of the cell phone." Interestingly, Cooper credits the 1960's TV show Star Trek (1966-1969) as important inspiration for the cell phone invention.7 Motorola offered commercial cell phones to the market beginning in late 1983;8 it wasn’t until 1996 that it was able to deliver a production-ready, consumer- focused clamshell mobile phone.9 The clamshell look, weight, and feel of Motorola’s 1996 StarTAC phone emulated Star Trek's Communicator. In the early 1980s, pre-breakup of telecommunications giant AT&T,10 a ten-million- dollar study was commissioned to predict the projected growth of cell phone subscriptions through the year 2000. McKinsey11 and Company was tasked with conducting the study. McKinsey's early 1980’s report predicted a total worldwide cell phone subscription market of 4 “Martin Cooper (Inventor),” Wikipedia, the Free Encyclopedia, October 27, 2014, accessed October 27, 2014, en.wikipedia.org/w/index.php?title=Martin_Cooper_(inventor)&oldid=631328568. 5 M. Cooper et al., “Radio Telephone System,” US3906166 A (September 16, 1975): 21. 6 “Brain Scan: Father of the Cell Phone | The Economist,” n.d., accessed October 30, 2014, http://www.economist.com/node/13725793?story_id=13725793. 7 “How William Shatner Changed the World - Martin Cooper, Mobile Phone Inventor - YouTube,” accessed October 30, 2014, www.youtube.com/watch?feature=player_embedded&v=wN-