INNOBLOG

According to a survey from the University of Tennessee Health Center, an estimated 40 million Americans suffer from allergies. For those 40 million, a story in the New York Times today has another example of "good enough health care just in time for that seasonal ritual of watching pollen counts and allergy forecasts.

Diagnosing allergies has long been the province of specialists using a labor-intensive skin prick test to isolate and measure patients reactions to specific allergies. For the uninitiated, the test involves injecting small amounts of allergens under the skin of the arm or back dozens of times and judging the severity of the reaction by the size of the red bump that results from the patients antibodies attacking the allergen. A full panel of tests can last hours and cost hundreds of dollars.

A radically different testing method involving a simple blood test has been around since the 1970s, but initially lacked the level of sensitivity afforded by skin prick tests. Ongoing research and development has improved the sensitivity and precision of blood testing, but the industry has been slow to adopt the new method. One factor, according to the Times, is that endorsing the now "good enough blood testing method threatens the lucrative testing business many clinics have developed. The revenue from skin prick testing goes to the allergist, while the money for a blood test goes mainly to the lab. Also, blood testing does not require the experienced eye to judge a skin reaction, meaning that patients could be tested by their general practitioners, another factor sure to alarm the specialists who dominate the industry.

So what does the theory of disruptive innovation suggest for the future of allergy testing? First, in the end simpler and cheaper almost always trumps the high end solution. The prospect of a single blood test sent out a lab for processing is appealing for both patients and insurance providers. Second, subjective tests and treatments offered by specialists are eventually supplanted by rules-based diagnosis. Recent news is filled with examples of medical procedures migrating from the specialists office to the general practitioners practice to (eventually) the home remedy. Allergy testing seems poised to repeat the pattern. In fact, MinuteClinic has already started offering $60 allergy testing with their quick service model. Finally, "pain in the market is a good indicator that consumers will be amenable to alternative solutions. Large numbers of un-diagnosed or self-diagnosed allergy suffers have been scared away from the doctors office by the prospect of skin testing. Speaking from personal experience, 50 pin pricks followed by a few days of freaky looking arms, constitutes pain in the market.