The New Playbook to Lead in Healthcare

Standing on the Threshold

Liminal is one of those words not often used. By definition it means "relating to a transitional stage of a process" or "occupying a position at a boundary or threshold." This is where we find ourselves in healthcare. Not where we once were and not yet where we will be. A liminal place, a threshold of sorts with vast promise and potential risk.

This is where we find ourselves in healthcare. Not where we once were and not yet where we will be. A liminal place, a threshold of sorts with vast promise and potential risk.

The future of healthcare is uncertain and will be altered in significant ways. Over the recent weeks we've learned of CVS Health buying Aetna and UnitedHealth buying DaVita. Retail pharmacies purchasing insurance companies and insurance companies purchasing physician groups. Each seeking leverage, scale, and the ability to compete. 2017 brought us mergers, acquisitions, venture capital, mind-bending technology, and a cadence of change bringing a whole new set of challenges. And we're just getting started. 

The most radical challenges we face are rooted in this: A cultural transformation of traditional healthcare through disruptive technologies. The linked article is written by Dr. Bertalan Mesko' in which he describes the many possible futures of healthcare. "With the rise of digital technologies, such as artificial intelligence, robotics, virtual reality/augmented reality, telemedicine, 3D-printing, portable diagnostics, health sensors, wearables, etc., the entire structure of healthcare, as well as the roles of patients and doctors, will fundamentally shift from the current status quo." A statement worth repeating and pondering:

"...the entire structure of healthcare, as well as the roles of patients and doctors, will fundamentally shift from the current status quo."

Crossing the Threshold

Consider this article with a similar tone: Study: IBM's Watson Found Cancer Treatments That Doctors Overlooked. The article concludes IBM’s Watson is helping doctors identify treatment options for cancer patients — and it is even suggesting solutions that humans failed to see. This follows a perspective shared in early 2017 at the Big Data and Healthcare Analytics Forum, proposing that artificial intelligence, machine learning and cognitive computing systems will replace a number of human jobs, even those requiring higher education, including some doctors.

Leonard D'Avolio, CEO of Cyft and Forum presenter, holds strongly to the opinion that if a cognitive computing system is better and cheaper than a provider, it would be unethical to not use that system.

“In any part of healthcare where a human is interpreting data or images, when a computer does a better job than a human and costs less, the argument could be made that it would be wrong not to use a computer,” - Leonard D’Avolio -

Using the computer does not replace the human. It augments the human's capabilities and adds greater value. All of this brings us to a threshold. A place of undiscovered possibilities: how can we create immediate access to what is needed most in healthcare for every person, wherever they are?

Historically, a patient's first stop was a trip to their local primary care physician. Then, if needed, referral to a specialist. If absolutely necessary, a final stop to what some have called "destination healthcare"; Mayo Clinic, Cleveland Clinic, etc. Well-known national brands of clinical excellence in a distinct geographic location.

Is it possible to cross the threshold of the best available clinical insight being accessible to anyone from anywhere? It would be wise to consider what happens to current roles and structures when healthcare consumers have ability to access diagnostic and treatment protocols any time, from anywhere.

It would be wise to consider what happens to current roles and structures when healthcare consumers have ability to access diagnostic and treatment protocols any time, from anywhere.

7 New Realities Shaping Healthcare Strategy

How we choose to see the world and what we believe about the future will influence the actions we take today. So much is uncertain, but if we're truly paying attention many evolving patterns are becoming clear. Here are 7 strategic implications of coming radical shifts from the status quo. The currents are already moving in certain directions and with growing intensity.

These proposed implications are offered to spark discussion among physicians, clinical teams, as well as senior leadership and governance members. It would be valuable to explore each of these perspectives and to find meaningful, action-oriented responses to each topic.

1. Recruiting and retaining clinicians to a specific location will diminish as a competitive advantage in healthcare. How fast, no one knows. But change is moving rapidly and picking up momentum. Thinking through the implications of this reality will be vital for future success.
2. Access to virtual clinical platforms, offering a patient the most current and proven treatment methods, is central to future healthcare organizational success. Thinking through who will be gatekeeper to these platforms, how access will be granted, and service model implications will be vital.
3. Supplemental offerings surrounding these platforms will become central to future competitive advantage. Integrating these pieces into a seamless offering will be a challenge. The role and identity of provider organizations will become increasingly a collection of entities with constantly shifting players. Shared governance and co-branding will be critical.
4. Provider roles will shift dramatically requiring repositioning and support. Clinical knowledge, which now doubles every 18 months, will become more accessible to individuals: directly, anytime, and anywhere. Leveraging AI as an extension of provider expertise will be a necessity. It is vital to discuss change management and the enhanced role of providers in this scenario.
5. Competition among clinical platforms will increase. Vetting and managing a portfolio of platforms will become a necessary competency of healthcare organizations. Building these competencies into your team will be critical.
6. As patients access clinical platforms, healthcare organizations will need to significantly enhance digital engagement, consumer experience, and "co-creating" service pathways with patients. Provider organizations will need to shift from "place based" and "knowledge holder" to "virtual" and "trusted navigation partner". Leading organizations will be those who become the most trusted partners in navigating clinical platforms that are accessible 24/7/365.
7. The above trends will have significant implications on space designated for clinical purposes. Medical spaces, now designated to diagnostic efforts, are on the threshold of shifting to digital or virtual platforms. To put this in perspective, let's recall the size of the first computer, first stereo or boom-box, television, and telephone. They are all now one integrated whole which fits nicely into our front jacket pocket. Designing with efficiency and simplicity is vital. A good article Healthcare Without Bounds: the future of health reflects the spirit and approach of this effort.

What did I miss? What trends are you seeing? Let's start a conversation.