Imagine for a moment that the year is 1902, and we are in New York, and need to get to England in less than a week. And the only way we can currently do it is by ship, and the fastest ships take over a month. We can try as hard as we can to achieve our goal by thinking small – tweaking the design of the ships hull, putting in a better engine, studying the tides, calling the boat builders to a conference. And none of these will work.

What we need to do, and what happened the next year, is to start to think big – to reframe the problem not as how do we make boats go faster, but to ask is there an entirely different way to cross the ocean – and the answer which is obvious to us now, is to do what the Wright brothers did, and learn how to fly – and now we can cross the Atlantic in hours not days or weeks.

A century later, we are at the same point in health care. Health care systems across the globe face an unprecedented set of challenges, including rising costs, labor shortages, fixed or falling reimbursements, increasing levels of uncompensated care, and increasing regulatory scrutiny. In addition, we face the rise of consumer directed health plans, changing payment strategies including pay for performance, and increasing competition from retail medicine. It is not clear that our current models of care can withstand these pressures, or that simply incremental improvement can get us to where we need to go.

What we need, like the scenario above, is real innovation in order to meet the unprecedented challenges we face.