“You can’t create a disruptive business inside an incumbent business.”

Jon Lax wrote an insightful post about a month ago that I haven’t stopped thinking about since. Teehan+Lax have a “zombie product” they named Image Spark, an image collection service similar to Pinterest (but born way earlier). The service, with 90k unique visits, is not exactly dead, yet it is not alive either; there are no updates planned, no person driving it forward, no future plans. Teehan+Lax has decided to give up the ghost on this one for lack of infrastructure (and will) to sustain and nurture the product.

What interested me was something Jon wrote in the comments. “The issue isn’t having interesting problems to work on. We have a long list of ideas. It’s that you can’t create a disruptive business inside an incumbent business. Any idea will flounder without proper focus and a 3-4 year investment timeline.” Lax goes on to cite Basecamp as a successful product for 37Signals, which “got the resources (capital and human) it needed because it fueled the incumbent services business of 37Signals. It was able to take root because it wasn’t disruptive but highly complementary.”

So what I gather is that to succeed, a product needs:

  • 3-4 year investment timeline
  • focus, human resources, and capital
  • freedom from OR complementary services to an incumbent business

The last point especially made me think about initiatives amongst healthcare organizations. Can a single hospital or a single health startup disrupt the network of archaic but established practices in the health system? Can a department, embedded within a large incumbent organization disrupt the hospital’s own practices? Can an individual nurse, doctor, or designer disrupt a department? Is it true that only those innovations that complement the existing strengths of a system have a chance of making it?

Designers entering health and startups looking to disrupt healthcare would do well to consider how their skills or their businesses complement existing systems. It is easy to enter a new space thinking your skill or your product is so rare that it must be valuable; it is much more difficult (and humbling) to understand why your role or product wasn’t there already and to imagine what you can do to work within those limitations to still accomplish something meaningful. As ever, it is easier to criticise than to come up with a solution.

This is not to say we should be thinking smaller, but certainly more realistically. It is possible to think big as well as practically. In health, being a visionary doesn’t necessary mean changing everything, not all at once. It means using the resources you have to do the best you can during the time you have. It means knowing when to cut your losses on a project – as Teehan+Lax are doing with Image Spark – or to pony up the resources to keep it moving forward. Otherwise, products and projects become stale and just as useless as if they’d never seen the light of day.

On one final note, disruption is not always the real goal. We hear so much of that word from every  young startup that if we were all successful, our healthcare systems would be even messier, more chaotic and less effective than they are today. Maybe we simply mean to evolve the current technologies – to bring them up to speed, take them up a notch, or to complement them – or to create an environment where innovation can thrive.

I’m going to keep mulling this over, myself. It seems an important distinction. I welcome your thoughts!