Perspectives

Demanding Disruption: A New Approach to Health Care Innovation

Doug Given
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Has there ever been a sector more ripe for disruption than healthcare? The current model is unsustainable in its cost, its percentage of GDP expenditure, and its ineffectuality. Dramatic change is not only appropriate, but urgently required. Concurrently, there has never been a more opportune time for healthcare transformation. A perfect nexus is formed by insights from physicians practicing in a protean landscape everyday, patients who now communicate and connect more effectively than ever before, technologists who are leveraging mobile, collaborative, and cloud innovations at unprecedented scale and policy initiatives with a focus on value. Unfortunately, much of this potential remains largely unmined.

It’s not that inventive action hasn’t been attempted to address our healthcare system’s deficiencies, but implementations have been slow, segregated, and disjointed. Why? Many applications directed at the system have been built by technologists without deep understanding of healthcare, or developed by healthcare managers without strong enough technology backgrounds. Productivity enhancements facilitated by modern technologies in parallel industries have not been widely conveyed to the healthcare field—philosophically, systemically, or materially.

Take, for example, the issue of chronic disease. Now estimated to account for 80% of the costs in our healthcare system, the way we treat chronic disease obviously deserves scrutiny. Yet we continue to be mired in a legacy healthcare structure centralized on acute, intermittent, episodic care in hospitals and ambulatory care centers and doctor’s offices. When we’re sick, we engage. When we feel better, we disengage. There is no incentive in continuity. There is limited opportunity to drive insight about prevention. Managing and mitigating chronic disease, selecting and implementing available alternates, and competently moving the care from the institution to the community to the family, with more personal responsibility through behavior modification, coaching, and support for the patient—all of this is logical, practicable, and scalable with the aid of modern digital tools, amplifying physician engagement. But it isn’t being done. It’s estimated that we could reduce current health care costs by 40% without another single technological innovation if we could just implement integrated and comprehensive use of our currently available technologies. Imagine if more of this missed opportunity cost were redirected to inventing cures. So, as some have said, the future is already here. It’s just not very well distributed or utilized.

Engineering this future in broad terms requires committing to a fundamental shift in vision. The focus must move away from maintaining the diffuse individual inputs in healthcare delivery, and instead be redirected toward measuring the value of collective outcomes across the system. This priority shift is not only applicable to tackling chronic disease, but can also catalyze transformative opportunities in similarly antiquated healthcare customs and institutions.

Resetting the objective needs to be followed by zealous devotion to systemic and material change. This is where technology and developing physician management and leadership skills can and will power healthcare disruption. However, it will require the informed and collective effort of fundamentally disparate stakeholders to succeed at scale. We have the knowledgebase. We have the human capital and technology. All we lack is synergy.

But that is about to change.

— Doug Given is Board Director at Health2047.

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