Point-of-service nerve conduction studies: an example of industry-driven disruptive innovation in health care.

Nerve conduction studies (NCS) and needle electromyography are useful and established diagnostic procedures for evaluating patients with signs and symptoms of neuromuscular disease. Although technological advances have occurred since the introduction of commercial electromyography instrumentation in the 1950s, most improvements have been evolutionary and were designed to benefit traditional users--neurologists and physiatrists specializing in electromyography. In the past seven years, instruments have been introduced that automate NCS and thereby enable a broader group of physicians, including internists and orthopedic surgeons, to perform these studies and utilize electromyographic data in the care of their patients. Automated NCS devices are an example of what Clayton Christensen terms a "disruptive innovation." In this article, automated NCS is contrasted with traditional electromyography, and the challenges and opposition to its widespread adoption are explored.