Just prior to the pandemic, we asked our members what they think will be the biggest disruptor in healthcare for the year ahead and why. We deliberately kept the disruption question pretty open ended, despite the fact that there are hundreds of potential answers, from disruptive innovation to disruptive processes. But we did see some themes emerge, which I’ll get to in a second.
From my non-scientific review of the conversation, almost 60 different disruptors were mentioned. On one hand, it would be great to see everyone agree that a particular disruptive innovation or process is the disruptor of the year. However, what this really shows is the broad range of perspectives and issues that comprise a transformed health environment. This is great, as it means we have a lot of work to do, but also a lot of listening and collaboration will be required to make progress.
I’d like to thank each of you for your thoughtful responses and the many side conversations that resulted. Here, in no particular order, are some highlights of the discussion.
Even before the pandemic, telehealth was mentioned more often than any other topic in the thread. Michael Fishweicher noted that telehealth’s future was set when Centers for Medicare and Medicaid Services said it would start to reimburse for the service. “I’ve had my finger on telehealth’s pulse for quite some time,” he said, “but once Medicare dropped that wonderful news, as expected, all major insurance companies followed.”
Fishweicher’s comment provides a great example of laying the groundwork, piece by piece, to build new capabilities of the health system. Preethi Lakshmanan raised an interesting point. “I find teleconsultation and second opinions will be the next biggest disruptor for medical service professionals,” she said and added that regulations and treatment policies need to be in place to reduce the chance of incorrect diagnoses or unnecessary treatments—both of which raise costs despite the intent of using this technology. Randy Rutledge supported Lakshmanan’s observation, noting that consumers have been “doing this for years,” and because all medical care is not equal, “consumers must seek the best care to ensure life quality.”
Before we leave the topic, Manuel Morales acknowledged the presence of hundreds of disruptive innovations, and asked whether they are affordable. He pointed out that for “most of the ecosystem, they’re not.” He said there “should be a shift in how new remote solutions are easily integrated” into tools used by both professionals and the general public to improve affordability for “any budget and geographic context.” Finally, he said, “no disruption will have an effective impact in society if we are not able to democratize its use.”
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Artificial intelligence and machine learning were also mentioned throughout the discussion, which was expected. There were some interesting comments about the development of conversational AI and the evolution of artificial emotional intelligence. Both of these would be valuable in the home environment, which is the next frontier.
Home health embodies many of the concepts considered disruptors, and range from the capabilities of telehealth to patient engagement and as noted above, changes in policies that enable innovative change. It’s also a great example of how technologies enable change, but don’t strictly represent the change itself. It’s all in how the technologies are used.
The conversation around disruptive innovations certainly mentioned several technologies, but it had, at its core, a fundamental theme around the array of change elements that are not strictly technologies.
“Disruption will most likely come from technology,” said Stephanie Smith, “and how people use technology.” That same theme is supported by Dawn Lang and others, who mentioned an internal disruptor: staffing. Specifically, she said allowing “greater mobility within providers” can help upskill the workforce “to fill high-demand roles that are struggling to be filled. Pathways from [certified nursing assistant] to [registered nurse] as an example.”
How else might technology enable other disruptions? “Patients, we as a people, are requesting and wanting to have more time with a physician that knows them holistically,” said Holly Arends. To achieve that, she said “we will see the tide continue to move toward selecting physicians based on their ability to access information about the patient, provide services that are tailored to the patient, their life and lifestyles,” and other features. “We are seeing many of these things coming to fruition and with this progress I believe patients will drive many of the disruptors that are yet to come.”
So patients are disruptive drivers, or as John Miluzzo put it, the most promising “disruption opportunities will likely be consumerism. Consumerism,” he said, “will drive policy, industry, [mergers and acquisitions], brick and mortar, education and training, and telehealth/remote technology investments.” Finally he said, “technology seems to have the most promise in the short-term to delivery what consumers want now, with policy and culture disruptions coming over the next three to five years.”
Those cultural shifts will shift toward individual accountability and policy will play a role in moving towards value-based care, according to Miluzzo. “Approaching our challenges with a higher-purpose conscious capitalism approach, as some in healthcare are now doing, would make everything an opportunity, and this is itself one of the big disruptions.”
The wide-ranging opinions were instructive. I enjoyed the comment calling for “higher-purpose conscious capitalism,” as it captures the challenges we face in transforming the health sector. The two ideas can seem at odds with each other. But why can’t we have both?
I also believe this conversation shows us that solutions are not limited to the technology domain. While technology has its place and is key in helping each of us become more informed stakeholders in the quest for better health, it’s only when disruptive innovations are harnessed and partnered with human ingenuity that we will build a more efficient health system.
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Originally published February 11, 2020; updated June 29, 2020