HSS CEO Lou Shapiro: Disruption is a good word

Healthcare is constantly at the forefront of today's news cycle. A recent Wall Street Journal article discussed the future of hospitals and a shift from the traditional inpatient, full-service hospital to ambulatory surgery centers, outpatient clinics and microhospitals, while an op-ed in The New York Times questioned if the hospital was obsolete.

Obsolete is a strong word. Where I am – at HSS – we are a healthcare organization that includes a hospital (the New York City-based Hospital for Special Surgery). The hospital is not obsolete; it is a very important part of the healthcare system and offers a broad array of services.

We are seeing new examples of traditional players blurring the lines in healthcare, with mergers like CVS and Aetna, and UnitedHealth and DaVita making top headlines.

Organizations outside of the healthcare industry are also becoming players, with the collaboration between Amazon, JPMorgan Chase and Berkshire Hathaway front and center. Additionally, there is the previously announced Health Transformation Alliance – two groups of employers 'taking the bull by the horns' and working to change how healthcare is delivered.

With all of this going on, there is constant talk that the healthcare system is broken. It's not 'broken'. Every day, millions of people receive care, with lives being saved or improved. Researchers and providers constantly develop new knowledge to help improve care, allowing the industry to do things we never thought possible.

The healthcare system is not broken. It is complicated. Too complicated. And it certainly can be made better. Much better.

With all of this in mind, the key word to focus on in 2018 and beyond is disruption. Words that begin with 'dis' are typically construed as negative, but in this case, it's not negative. Disruption in the industry can contribute to positive changes and impact the way we provide care, as well as the cost of that care.

The industry is not structured in the way that it needs to be in order to be successful. Consolidation, blurred lines between organizations and employers asserting their influence all provide an opportunity for disruption. The question is will this disruption happen from the outside-in or from the inside-out?

Disruption from the outside-in will come from organizations like Amazon and Google using their technological intelligence to drive change or utilizing their size to encourage innovation. Inside-out disruption will come from historically separate players in the healthcare industry blurring the lines between them and using their influence to change how and where healthcare can be delivered, as well as how it may be paid for.

Then there is the continued consolidation of hospitals and health systems becoming bigger (and bigger).  In my view, bigger isn't better. Bigger is just bigger. Better is better.

Finally, there are those organizations that have the potential to make significant contributions to disruption by leveraging their quality, value and knowledge. Let's use the organization I work at as an example. HSS is a leader in the field when it comes to musculoskeletal health. Other organizations have similar knowledge and expertise in other areas of medicine. We have a responsibility to either contribute to disruption from the inside-out on our own, or to partner with an another organization to cause disruption, which can make a real difference in providing affordable and effective care, and a stronger healthcare industry.

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