7 Hospital and Health System CEOs: What Disruptive Innovation Means to Me

Disruptive innovation is broadly defined as the creation of new market values and breaking away from existing market trends. Like many other buzzwords, its generous definition is open to interpretation among hospital and health system leaders. Becker's Hospital Review asked seven current presidents and CEOs to explain what the term means to them, their organizational strategy and the healthcare industry as a whole.

Larry Anderson, CEO of Tri-City Medical Center in Oceanside, Calif. "Disruptive innovation is the process of creating a new market by creating new expectations and values and, thereby, replacing an existing market. At Tri-City Medical Center, we have used this concept to create value and new processes. More than a year ago, we introduced robotic spinal surgery to southern California through the use of the Mazor Renaissance technology, which allows for a simple pre-surgery scan to serve as the 'roadmap' for the precision placement of rehabilitative hardware. The process, available in only a handful of U.S. hospitals, produces accuracy that cannot be equaled by the most experienced surgeons, and avoids the need for multiple doses of radiation in the surgical suite. Accuracy of placement reaches 99 percent with experienced surgeons.

Second, we have used a variety of techniques to reduce the incidence of readmissions in the diagnosis of heart attack, heart failure and pneumonia with amazing success. Essentially, we have put processes in place that ensure every patient [is] followed with hospital resources post-discharge to ensure they have and are using the appropriate medications. We also ensure they have access to a physician, when necessary, irrespective of ability to pay. While this process goes above and beyond our legal obligations, the results are impressive. Tri-City Medical Center now ranks 14th in the nation in lowest readmission rate for heart attack and 84th in the nation for lowest readmission rate for heart failure. It has achieved a rate of 136th in the nation for lowest readmission rate for pneumonia. While this has added some expense, it is the right thing for our community and our patients and will eventually become the 'norm' for all hospitals."

Kenneth L. Davis, MD, President and CEO of The Mount Sinai Medical Center in New York City. "Technologies that change the direction of medicine are disruptive. They can be as diverse as how we deliver healthcare services, drugs that markedly change a patient's prognosis, or new surgical procedures that offer outcomes previously unachievable. From that perspective, moving from fee-for-service medicine to risk management, some of the new drugs to treat various cancers, and mitral valve repair instead of mitral valve replacement, are all examples of disruptive technologies."

Robert C. Garrett, President and CEO of Hackensack (N.J.) University Health Network. "Hospitals and health systems across the country are facing a state of 'controlled schizophrenia,' as I refer to it. This represents the dilemma of moving forward with accountable care organizations in order to keep our patients well and out of the hospital, while keeping in mind that the majority of a hospital's reimbursement comes from hospital inpatient admissions.

As an industry, we need to focus on other areas of business growth to compensate for reduced admissions. By way of example, Hackensack University Health Network [recently formed a] joint venture partnership with community physicians and United Surgical Partners International in the acquisition and operation of two ambulatory surgery centers, and [established a] clinical affiliation with MinuteClinic, the retail healthcare division of CVS Caremark. Implemented appropriately, these changes could also help lead the way toward opening areas of opportunity for other aspects of care. The outcome is a healthcare delivery system that results in higher quality and is less costly.  

This is an exciting time for the healthcare community. HackensackUMC is optimistic that changes made to accommodate upcoming reform will eventually help to better serve our community and patients while maintaining a stable financial position."

Carlos Migoya, President and CEO of Jackson Health System in Miami. "Too often, the corporate world thinks of disruption as a negative — we talk about a disruptive employee or a disruptive incident. At Jackson Health System, we think about the ways the Beatles and Rolling Stones disrupted music and Julia Child disrupted home cooking and Jonas Salk disrupted medicine. Disruption is a natural part of innovation. It's coming to our industry whether we like it or not via healthcare reform, increased competition and shifting market forces. We can be overtaken by it or we can leverage it and shake off our complacency."

Susan Nordstrom Lopez, President of Advocate Illinois Masonic Medical Center in Chicago. "In healthcare, every major advance in science and technology is accompanied by a low-tech response. Each miraculous high-tech development creates an echoed demand to re-infuse medicine with a high-touch, integrated and compassionate approach. For example, at Advocate Illinois Masonic Medical Center, an urban, community-based teaching hospital, the demand for a comprehensive hospice program accompanied major advances and life-sustaining treatments. Our Alternate Birthing Center was a success in bringing much sought-after home-birthing into a setting offering nurse-midwife-assisted deliveries in a safe hospital setting.

Now, as ACOs [are] supported by sophisticated computer-based and data-intensive outcomes tracking systems, we're simultaneously reminded that each patient is best served by coordinated, patient-centered care.

In my experience, disruptive innovation is a reminder of what we can't afford to leave behind as our skills develop. Listening to patients is critical — not just to what they say, but to what their actions tell us. Home medical testing, surging Google self-diagnosis and the use of complementary treatment modalities constantly remind us we can't simply offer a menu of stand-alone islands of excellence. The care we offer to the patients and communities we're privileged to serve must be accompanied by a system of integration, assuring they won't be sacrificing the long-term partnership, coordination or care they need now more than ever before."

Randy Oostra, President and CEO of ProMedica in Toledo, Ohio. "The current model in healthcare is unsustainable. Disruptive innovation challenges the status quo and our current business models. The past challenges to the delivery of high-quality, cost-effective care have now been replaced with a whole new set of disruptive changes that include broadened access, significant payment reductions, new care settings, advances in information technology and an evolving 'revolutionary' model of population health. Disruptive innovation brings about reduced costs, higher quality and greater access or convenience, often while meeting a significant, underserved need. By offering more than what the country and its consumers currently need or want in a way that is simpler and less costly, we are seeing disruptive innovation can be a game-changer and is challenging everything we are doing."

Chris Van Gorder, President and CEO of Scripps Health in San Diego. "I prefer to use the term 'sustaining innovation' rather than 'disruptive innovation' because I think it more accurately reflects healthcare as a 'mature' but rapidly changing business. Sustaining innovation refers to evolving an existing market into one that creates better value and, in my opinion, that is the most important thing we can do in healthcare right now. There are many examples of work being performed right now to increase the value equation for our patients, providers, employees and society. Certainly, finding ways to improve quality while lowering costs will require new and innovative processes.

Tightly linking ambulatory with inpatient [care] or focusing on 'wellness' versus just 'illness or injury' will require significant change and innovation. And the development of new care management systems both within and outside hospitals will create more value. I suspect many of the changes ahead will be disruptive — certainly when compared to our past — but I prefer to focus on the future ahead as a time to focus our research and innovation so we can both sustain and grow in our importance to patients and society."  

More Articles on Hospital Leadership:

Chuck Lauer: Keep it Simple
12 Most-Read Hospital Management Stories of 2012
10 Ideas That Hospital and Health System CEOs Need to Ditch

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