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3 Themes for Change in Healthcare—and 4 Rules for Knowing When

Mark Smith

Chief Innovation Officer, MedStar Health

In previous blogs for 1776, I’ve discussed the reasons large organizations are in need of the nimbleness, energy and future focus of startups and how an innovation center embedded within that large organization can provide “startup mojo” to its organizational parent by functioning as a “virtual startup” from within. This blog summarizes three themes of change in health care and four simple rules for identifying when the time is right for innovation.

How we think of health and the provision of health care is changing dramatically and rapidly. The federal Centers for Medicaid and Medicare Services has identified a “triple aim” for health care, which I am phrasing here in the negative: Health care in America is costly, often of variable quality, and often a poor experience for the patient and family.

That all is going to change in the next 10 years.

How? Here are my top three themes for healthcare change.

1) The patient will be in charge, using all the new digital tools and technologies that are increasingly available to them. The title of Dr. Eric Topol’s new book says it all: The Patient Will See You Now.

2) The financial incentives will align with the clinical incentives for doctors and healthcare systems. Right now these incentives are, for the most part, diametrically opposed. In our traditional fee-for-service environment, it is in the provider’s financial self-interest for the patient to consume healthcare resources. Coming soon: Exit the pay-per-view, fee-for-service model; enter pay-one-time, subscription-based service. The provider’s financial interest will then align with the patient’s clinical interest—that he or she stays well, stays out of the hospital, and consumes fewer healthcare resources.

3) Healthcare systems such as MedStar Health—which in the past have been hospital-centric, providing episodic care for acute illness and injury—will transform themselves into broad platforms of health and care that are delivered in multiple ways, including at retail outlets, through virtual visits and in the home. We will inhabit the positive space of health and wellness, while continuing to provide extraordinary interventional care. And of course, all of these changes will run on an engine of data, vast amounts of data that, unlike today, will be meaningful, beautifully visualized, timely and compelling.

Health is personal. You have good health . . . until you don’t. When you have good health, it’s easy to take it for granted. But when you or someone close to you doesn’t, your whole world changes.

I have spent most of my professional life as an emergency physician, providing care at the two busiest adult emergency departments here in our nation’s capital. I have been “in the arena,” to use Teddy Roosevelt’s metaphor. But I also have been on the other side of the stretcher and have seen firsthand what the system looks like from there—and it was not pretty. Thus, changing the healthcare system for the better is very personal for me.

There are four rules for identifying when we as health care providers need to innovate to facilitate the necessary transformation of health care. Yet, these rules also apply to education, energy and transportation every bit as much as they apply to health.

Industries should innovate when…

1) When the only way to accomplish what you need to do is to perform a workaround—follow that clue.

2) When something similar is being done many quantum leaps better in another industry—port it over.

3) When you experience something (a technology, a process, an interaction) and your first reaction is, “There’s got to be a better way,” or, “I can’t believe that someone actually designed that”—innovation is needed.

4) When something hasn’t changed in 40 years—It is either a perfect design, like the paper clip or the Stanley Powerlock® tape measure, or it is crying out for innovation and we do not even realize it. Health care is crying out for innovation. We do many things the same way as our forefathers and foremothers did, and their forbearers before them.

Improvements in health care, as in education, have lagged behind change in other industries, and so there is huge opportunity to move fast and accomplish big things.

As Alan Kay, one of the pioneers of computer science and my graduate school thesis adviser, said a long time ago: “The best way to predict the future is to invent it.” Magic words, those.

Mark Smith

Chief Innovation Officer, MedStar Health

Mark Smith, M.D is Chief Innovation Officer of MedStar Health and the Director of the MedStar Institute for Innovation, where he leads a system-wide initiative to catalyze and foster innovation.…