Clayton Christensen, a thought leader on innovation states that it "sneaks in from below". Mainframe computers were replaced by smaller, faster and cheaper PCs, then replaced by smartphones. Simpler, convenient and less costly offerings to solve basic problems continue to improve, to the point that they appeal to the vast majority of users. [source]

In health care, nobody is better situated to drive innovation than a well-led community care agency. Community agencies have a pre-existing advantage in the fact they already use lower cost settings and less expensive professionals. Add to that technology, like telemedicine, online booking, other interoperable tools, and a good dose of patient empowerment, and the whole health care market can be disrupted. 

Improving patient / public confidence in self-managing conditions is vital to driving innovation. This means easier access to a greater basket of services. Innovative community agencies are not relying on the traditional access processes built for a bygone age. The majority of traditional health care services are delivered for the most demanding patients who are complex and require repeated interactions over time. This is the "5%" who gain the attention of major institutions like teaching hospitals and specialist physicians. In the mental health sector, for example, these are people with severe mental illness requiring hospital inpatient beds or assertive treatment teams. Access to these services should be heavily prioritized, using needs assessments, triage tools and screening algorithms. 

These services are not what most people need, and using these same complicated screening tools as a primary door to access for simpler problems is a waste of money.

Community agencies have the opportunity to deliver less expensive and more effective access processes than their complex, high cost institutional counterparts. For example, treatment for those with anxiety, mild depression or grief can be relatively simple and provided at a low cost. Virtual or walk-in single-session counselling is an economical, low barrier way to provide service to the many people who can benefit. Marketing this service so people can find and book it easily online, is vital. 

The winning community health agencies will use their low cost advantage to focus on what they can do well, with simple and transparent marketing, access, and service delivery. Then they can add additional tools like remote client monitoring, so that their relatively less expensive professionals can do progressively more sophisticated things, ideally in the client’s own home. The same playbook can be applied in every sector of health care. Failing to do this means care is expensive, inconvenient and many people will simply not get the care they need.