Lean Management Systems and Disruptive Innovation in Healthcare Industry

This paper discusses the adoption of Lean Management system and disruptive innovation in the healthcare industry. It covers the implementation of disruptive technologies like Artificial Intelligence, Robotics, and IoT in the healthcare industry.

Running Head: MANAGEMENT 0
w
Management

MANAGEMENT 1
Table of Contents
Introduction................................................................................................................................2
Lean Management Systems........................................................................................................2
Disruptive Innovation and technology.......................................................................................3
Disruptive innovation and Technology......................................................................................4
Disruptive innovation in the Healthcare Industry (MAP)..........................................................5
System Description....................................................................................................................6
Suggested Future State...............................................................................................................6
Conclusion..................................................................................................................................9
References................................................................................................................................11

MANAGEMENT 2
Introduction
In this paper, the changes in the healthcare industry including its process, practices
and operations will be discussed. In past 10-15 years, it had changed a lot producing lots of
medical advantages and enhancement in patient care.
This industry is also known as a medical industry, which is one of the world’s biggest
and fastest growing industries (Leventhal, 2013). It is typically divided into many areas
consisting of Hospital activities, human health activities and medical activities.
With the increase in demand for care, Healthcare systems are facing growing
challenges where their financial conditions are not improving and in some cases, it is even
worsening.
Over the past few years, this healthcare industry is adopting various management and
industrial practices, which make their operations in an efficient manner. In every hospitality,
the process of these operations was divided into several maps, which starts with the
registration of the patient to its treatment. For managing these processes in an effective
manner, various hospitals try to adopt the management practices of a well-established
company. This helps them to reduce costs and improve quality, as the rising cost of
healthcare is the biggest barrier to health coverage.
Therefore, to solve the problem of rising health care costs and service quality, many
hospitals adopting the approaches of the Lean Management system which evolves from one
of the prominent automobile car making company – Toyota Motors (Brandao de Souza,
2009). One successful example of a healthcare industry is at the Community Medical Clinic
in Missoula, Montana.
It has been estimated that around 53% of US hospital adopted this approach, which
leads to the enhancement of capacity, quality and safety while containing costs.
Lean Management Systems
This system is also known by its other name i.e. Toyota Production System (TPS)
which was found in the auto industry by Taiichi Ohno in 1990 (Greeve, 2017). This was
referenced to a Toyota model in which the management of the company faced manufacturing
problems.
Later, this Toyota Production System (TPS) was evolved which serve as a tool for the
knowledge and innovation. This all happen because of the lean principles, which include
(Meiling , Backlund , & Johnsson , 2012) –
 Identifying the value of a customer.
 “Value Stream” Management.
 Increasing capabilities of flow production.

MANAGEMENT 3
 Changing the mechanism to “Pull” for supporting the flow of materials at constrained
operations.
 Make zero waste and promote perfection.
Lean is a multi-faceted approach, which makes enterprise to perceive several
dimensions of the view. In 2006, it was implemented in the health care system and by 2009,
most of the hospitals are almost using this approach. The waste in the term of cost and time
also divided in to many ways like waiting time on information searching and materials,
excess of unnecessary motions, transportation of information by mail, cart or foot travel, time
spent of fixing defects (repairing of material or information) and producing of more
information than the consumer requirement (Davis, 2009).
Many researchers think that lean is a tool, which can be used to improve the efficiency in
the operations. However, it is not a tool and neither a system, Lean is a management style and
approach.
With the help of lean management tools (TPS), many tools were also derived like
value stream analysis, visual controls, root-cause analysis, spaghetti chart etc.
The most important tool of lean management i.e. value steam mapping defines the
value from the consumer perspectives and map the various processes to bring common
understanding which helps in finding the weakness that can be corrected (Martin & Osterling,
2013).
In addition, lean management can be called as the starting point of disruptive
innovation in any industry, which can make a company take a faster pace in leading the
industry with the help of innovation and creativity.
Disruptive Innovation and technology
“Disruption” is a process where small/new companies with fewer resources can able
to challenges well-established businesses. Disruptive technologies have the potential to create
a new marketplace by break through the usual product/technology capabilities and create a
competitive paradigm (Armstrong, 2017).

MANAGEMENT 4
Source: (Newbert, 2015)
The major benefits of disruptive technologies are (Ndubuisi, 2012)–
 Can create an immediate profitable environment
 Allow the business to quick entry into the competitive market
 Growth opportunities are high
 More capabilities in a shorter period of development.
In addition, various disruptive technologies which supports lean management and used in the
hospitals are mention below -
Disruptive Technology in Hospitals
 Artificial Intelligence – It is an area of computer science where machines are
programmed with various algorithms to learn and think like a human. In any business,
implementation of AI can help in saving time and money due its automation process
(Froese & Ziemke, 2009). It can also increase productivity through operational
efficiencies. AI will be the most significant descriptive technology as it can handle
and operate end-less amount of data with its radical computational power and
advances in deep neural networks. Various big hospitals are planning to use artificial
intelligence to replace traditional task performed by nurses and doctors. In London,
the ATI (Alan turning Institute) and the hospital made a contractual agreement for
three years with the aim to bring the benefit of the machine learning (AI) to the NHS
(National Healthcare Service) on a big scale. One of the simple tasks, which include
diagnosing cancer on CT scans for analysing, which A&E patients are seen. Before it
was done by the nurses but now it will handle by the AI algorithms (Devlin, 2018).
 Robotics – With the help of the software’s, AI algorithms and learning capabilities,
robots can handle any type and amount of work which previously done by humans
(Bekey, 2008). It is one of the fastest growing fields in healthcare, which started in the
process of surgery. In various large hospitals in Australia, Surgical robots like da
Vinci Surgical System are been used which help in the surgeries ranging from head
and neck to urology surgery (Marso, 2018). Their reason for using these robots in the
surgery is their flexibility and greater risks, which access them to the specific area and
provide physicians greater control over the procedure. The rate, precision and speed
are good which help in improving efficiency.
 Data and Cloud Technology – Gathering, sorting and accessing of relevant data
from the data cloud and thus help in saving time and cost. In the upcoming decades,
the healthcare industry will grow at a very fast pace and so is the data associated with
it. It is expected that data will the size of petabytes, Exabyte or even zettabytes. This
data will be collected from laboratories, medical equipment’s, EHRs and from the
patients themselves. Therefore, the cloud computing will offer an effective solution to
these problems. By using Big Data in healthcare with the alignment of cloud

MANAGEMENT 5
computing will gives new directions to the healthcare industry and medical models.
Boston Children’s Hospital is innovating on top of an open cloud system.
Disruptive innovation in the Healthcare Industry (MAP)
The modern industries encountered the problem of the operations in the
manufacturing process. To hold the position in the competitive market, an industry needs to
stabilize its production process with the help of lean management and disruptive innovation.
The first step in this process is to identify the bottlenecks in the operation process and
Value stream mapping gives a clear view of the information and material shows in the
organization.
Below is given a flowchart of a hospital emergency room in a view of VSM (Value
Stream Mapping) –
In the above flowchart, the patient is pushed into the system by the department of
hospitals. The more time, the patient being processed in the system with the various elements
i.e. Registration counter and nurse or doctor attendance, the more will be the havoc on the
system. One of the problems can also occur if the doctor is not available or in the emergency
room and so cannot attend to the patient.

MANAGEMENT 6
System Description
This proposed system begins with the making the patient ready to be services into
three groups. The first is through patient registration system where all details of the patient
will be noted first and enter into the system so that patient historical data can be check easily.
In the second or third case, the patient can be examined directly via a nurse or doctor.
The next stage will be started by the waiting area space or followed by ER room. The
nurse can also attend the patients who are allowed to sit in the ER room for the first stage or
initial check-up. Now, the nurse will start inspection patient problem and this check-up can
transfer to a doctor for further examination.
With the direction of doctor words, the nurse can bring medical supplies so that
doctor can treat in an effective manner.
Now, the next stage according to the flowchart will be departing instructions are given
by the prescribed doctor and a nurse can assist the patient while his/her departure. Each
information of departure will be listed in hospital records for later analysis.
One of the significant aspects of this full system is the efficient use of the scheduling
plan so that the patient has a steady glow to the door. In addition, the hospital map of the
emergency room deals with the real human people and not with the hardware and so the
acceptable amount of WIP cannot be evaluated.
Therefore, in the whole system, the flowing of information and materials in the
emergency room are established in a systematic way starts from the patient registration to its
departure and follow-up.
Suggested Future State
After the observation of the present state and identifying the bottlenecks, the first
reaction can be the implementation of a pull system by replacing the existing push system.
Using a large number of available elements for attending the patient can create large variation
and this can affect the quality of care if not focused correctly.
For making this state more efficient, this can be applied in the industry:
 A pre-scheduled appointment can prove to be an effective solution. For this, hospitals
can use the digital technology and allow users to book an appointment through just
their fingers.
 All in-process inventories must be evaluated after the end of the day with the help of
various advanced data management tools like ORG database, IBM and SAS Data
Management (Shethna, 2016).
 In addition, there is a need to well-equipped all the key areas of the service map with
the newborn technologies and those derived via lean management styles.

MANAGEMENT 7
The intersection of healthcare and disruptive technologies will rise to various market
opportunity (Crump, 2014). Various new strategies will be developed by the companies
so that to disrupt the market with the innovative technologies.
Several disruptive technologies can be used in the service map of healthcare and some
of these disruptive technologies are given below –
 IoT(Internet Of Things)
 AI (Artificial Intelligence)
 3D printing
 Medical innovation
 Robotics
 Autonomous Vehicles packed with AI algorithms.
Now, it will be discussed that how these technologies can be effectively fitted into the
organization.
IOT, which connects every element to the internet, can also help doctors to fill the gap
of geographic boundaries, which separate them from the patient. A robotic system named as
RP Vita relies on IoT help doctors by eliminating the problem of - how to visit more number
of patients in less time (Hornyak, 2013). Many IoT devices are also manufactured which can
be wear by the patient and the doctors so that to take up health issues on a continuous basis. It
helps the doctor to track the status of health in real time and allow numbers of practitioners to
monitors patients remotely and even patient can also self-monitor himself, which can reduce
the cost of person (doctor or nurse) visits.
IoT even produces an innovation, which makes easier to capture data from various
medical devices like respirators ad cardiac monitors, which were previously the biggest
challenge (Ianace, 2015).
In addition, it helps in improving the overall efficiency of the hospital by deploying
cloud-connected smart sensors, which also help to reduce cost in every stage of their
operations.
In the above-given stream map, IoT can connect all the way of information flowing
from every map of the emergency room.
The next innovation in the healthcare industry is in the term of AI (Artificial
Intelligence) which has altered the face of hospital management. AI helps in improving
medical records and treatment solutions by making possible to interact with the personal
medical history (Agah, 2013). With the help of digital innovation, it is now more effective to
collect, store and analyse the data, which leads to getting faster medical feedback.
For implementing AI in this service map of the emergency room, the most important
places to set up within is the – when the doctor examines the patient when doctor treat the
patient, patient history and vital analysis, and all in the alignment of the insurance firm.
Many hospitals also spend a lot of time and resources to build a good relationship
with the customers and any of these services are basic in nature that can be done via
technology. Model of CRM is significant for understanding queries of customers and

MANAGEMENT 8
providing correct responses relating to necessary sharing, appointment or certain other facts.
In relation to solving all these problems, AI aided chatbots are intrudes which provide
necessary solutions by using data of question and items (Marr, 2018). Therefore, healthcare
industry needs to focus on building these knowledge libraries.
Other innovations in AI fields are – tracking of ital. stats of ICU patients, health
insurance verification and decoding of lab result.
In the emergency room service map, AI can be used at various aspects like while
diagnosing the patient, during the treatment of the patient and during the time of registration
(Insurance verification).
The next other disruptive innovation will be known as 3D printing in the healthcare
industry. It is also known as additive manufacturing and the concept was aroused in 1984.
Global spending in 3D healthcare printing takes an upturn from last few years and the market
will be expected to be worth of 1.3 billion by 2020. Future 3D printers can able to build
various tissues and organs such as kidneys, hearts and liver with the help of bio-inks
(Ventola, 2014). This will lead to saving on more numbers of patient lives as they will not
have to rely on doctors for organ transplants. However, it is still a challenge today from
printing inorganic material into living cells.
With relation to the service map, this technology can help by elimination one of the
process in the row and that is the first time treatment of a patient by the doctor. As with the
time, even nurse will able to easily operate this technology and the time can be saved and
utilizes in the treatment of another patient from the side of a doctor.
Medical innovation in future can be in the direction of genetic editing, DNA testing,
using of protein biomarker to screen cancer and more. This can help the doctors at the
treatment stage (Consoli, Mina, & Nelson, 2015).
Using robotics also a part of changing healthcare system where robotic medical
assistants can help in monitoring the patient vital statistics and alert the nurses if there any
need for the human presence in the room. Also, this robotic application and algorithm can
automatically enter the information into the record of patient healthcare. Various hospitals are
started using robotic carts for moving various suppliers in the corridor and these benefits the
doctors to conduct surgery with full focus.
Robotic personal assistants can help a lot and Japanese have taken the lead to build it.
One of their machines is called Paro, which respond to the human speech and the other is
humanoid which aid y personal care, socialization and training.
This technology can be used in all the areas of the service map and with this
technology, hospitals can save a lot of time and cost. It can help in pre-stage of registration of
welcoming the patient and note down the necessary details in the hospital server relating to
patient name, address, type of disease, insurance verification etc. It can also be beneficial
between the time of waiting and treatment by understanding more about the disease and
symptoms. For supplying medicines and other material to the nurses or doctors, it will be
helpful.
One of the last but most important disruptive technology, which can benefit the
healthcare industry in many ways, is the autonomous vehicles. This project started 3,000

MANAGEMENT 9
years later but in the science fiction movies but in reality, it creates a stand today.
Autonomous vehicles include driverless cars, which can come in all sizes, shape, and create a
hope of making life easier.
In the terms of health-care industry, these autonomous vehicles can have faster
response time than the ambulances as normally; ambulances face many obstacles like driver
behaviour of not obeying traffic rules, the daily route from patient to hospital and non-
competent availability of tools to make inside treatment of the ambulance (Walker, 2016).
One of the most innovative disruptive technology, which can be used in personal life
or in the healthcare industry (as of their interrelations), is the autonomous vehicles and
ambulances.
From personal use perspectives, the rate of accidents can be reduced if one uses the
power of autonomous driving and this will ultimately lead to fewer deaths and injuries.
From health-care industry perspectives, it was founded that around 10 to 51 per cent
of patients stated that they could not able to get access to health care in a timely manner
because of lack of transportation.
This lacking area can be resolved with the launched of AI packed autonomous
vehicles which can help the hospital and patient in many ways like schedule the most
efficient map area from patient to hospital or vice versa, inside treatment in the ambulance
with the help of AI packed machines which can able to diagnose and cure in emergency
situation.
In addition to this, on-demand health service can also be proved beneficial where the
hospital “healthcare cloud” can provide nearby access and information with health services
based on the respective monitoring and feedbacks (Soman, 2011). For example, MedStar
Health in Maryland has collaborated with Uber to help transport the patient to and from
appointments. This will help in decreasing missed appointments and expenses as according to
the journal of the American Medical Association, around 3.6 million Americans miss medical
appointments every year due to the transportations problem.
Conclusion
Most of the sectors have historically led in the implementations of lean principles and
the healthcare industry is one such sector. Financial pressures are forcing hospitals around the
globe to finding for appropriate ways for the cutting of costs and improving efficiencies.
This report stated that many hospitals have already implemented lean management
principles in their systems and now their focus is to make disruptive innovation with the help
of booming technologies.
Working with those above disruptive technologies is a challenging task but the
benefits of after implementations are more beneficial for the whole industry and the result of

MANAGEMENT 10
this study indicating the layout in process of the map influenced complete healthcare
perception of quality, cost-effectiveness and safety problems in a process.
Although the process map showed the whole process of the information and material
flow in a single image, it is a vitally important aspect of how that process proceeds.

MANAGEMENT 11
References
Agah, A. (2013). Medical Applications of Artificial Intelligence. US: CRC Press.
Armstrong, P. (2017). Disruptive Technologies: Understand, Evaluate, Respond. New York:
Kogan Page.
Bekey, G. A. (2008). Robotics: State of the Art and Future Challenges. USA: World
Scientific.
Brandao de Souza, L. (2009). Trends and approaches in lean healthcare. Leadership in health
services, 22(2), 121-139.
Consoli, D., Mina, A., & Nelson, R. R. (2015). Medical Innovation: Science, technology and
practice. New York: Taylor & Francis.
Crump, N. (2014). Top 8 disruptive technologies in healthcare. Retrieved from
https://www.auroracomms.com/uncategorised/top_8_disruptive_technologies_in_heal
thcare
Davis, J. W. (2009). Lean Manufacturing: Implementation Strategies that Work : a Roadmap
to Quick and Lasting Success. New York: Industrial Press Inc.
Froese, T., & Ziemke, T. (2009). Enactive artificial intelligence: Investigating the systemic
organization of life and mind. Artificial Intelligence, 173((3-4)), 466-500.
Greeve, M. (2017). My Shadow and Me - Lean and the Toyota Production System (TPS).
Retrieved from https://www.linkedin.com/pulse/my-shadow-me-lean-toyota-
production-system-tps-mitt-greeve
Hornyak, T. (2013). Medical robot RP-VITA gets FDA approval. Retrieved from
https://www.cnet.com/news/medical-robot-rp-vita-gets-fda-approval/
Ianace, P. (2015). IoT - Empowering Remote Healthcare Monitoring. Retrieved from
https://www.linkedin.com/pulse/iot-empowering-remote-healthcare-monitoring-pete-
ianace
Leventhal, R. (2013). Brookings: Healthcare is the Fastest-Growing Industry in the U.S.
Retrieved from https://www.healthcare-informatics.com/news-item/brookings-
healthcare-fastest-growing-industry-us
Locklear, M. (2017). Toyota's $100 million fund will back AI, robotics startups. Retrieved
from https://www.engadget.com/2017/07/11/toyota-100-million-fund-ai-robotics-
startups/
Mannes, J. (2017). Toyota launches venture capital fund targeting artificial intelligence
startups. Retrieved from https://techcrunch.com/2017/07/11/toyota-launches-venture-
capital-fund-targeting-artificial-intelligence-startups/

MANAGEMENT 12
Marr, B. (2018). How Artificial Intelligence Is Making Chatbots Better For Businesses.
Retrieved from https://www.forbes.com/sites/bernardmarr/2018/05/18/how-artificial-
intelligence-is-making-chatbots-better-for-businesses/#149c18944e72
Martin, K., & Osterling, M. (2013). Value Stream Mapping: How to Visualize Work and
Align Leadership for Organizational Transformation. United States: McGraw Hill
Professional.
Meiling , J., Backlund , F., & Johnsson , H. (2012). Managing for continuous improvement in
off-site construction: Evaluation of lean management principles. Engineering,
Construction and Architectural Management, 19(2), 141-158.
Ndubuisi, E. (2012). Disruptive Technologies, Innovation and Global Redesign: Emerging
Implications: Emerging Implications. USA: IGI Global.
Newbert, S. L. (2015). Small Business in a Global Economy: Creating and Managing
Successful Organizations [2 volumes]: Creating and Managing Successful
Organizations. Santa Barbara: ABC-CLIO.
Said, C. (2016). Nauto dashcams monitor human drivers to help autonomous vehicles.
Retrieved from https://www.sfchronicle.com/business/article/Nauto-dashcams-
monitor-human-drivers-to-help-10628742.php
Shethna, J. (2016). Retrieved from https://www.educba.com/database-management-system/
Soman, A. (2011). Cloud-Based Solutions for Healthcare IT. New York: CRC Press.
Ventola, L. C. (2014). Medical applications for 3D printing: current and projected uses.
Pharmacy and Therapeutics, 39(10), 704.
Walker, J. (2016). Ways Autonomous Vehicles Are Disrupting Healthcare. Retrieved from
https://www.healthitoutcomes.com/doc/ways-autonomous-vehicles-disrupting-
healthcare-0001