The gospel of innovation in healthcare needs new words.
A $4 trillion system of markets is stuck in a loop in time, kinetically trapped in “crisis” mode for the past 50 years because the taxonomy used to frame “transformation” and “disruptive” conversations rarely moves past “patients are at the center of everything we do.”
The whole is on autopilot, only this time it’s being guided by the promise of algorithms to deliver the sunny end state: patient empowerment and technology as the future of healthcare. It’s a very functional vision. What seems to be missing, in simple terms, is thoughtful action and active thinking around outcomes as the basis for market strategy.
Which is to say most of the pieces in the economic system defined as healthcare have been working with the same set of ideas to create and compete in the same way: a variation of ‘'my patient centricity is better than your patient centricity’. Ultimately, and unsurprisingly, we’re getting the same result: a “burning platform” from spending about 18 percent of GDP on healthcare.
Except the output doesn’t match the input.
"With health care, we have the best in the world — doctors, hospitals, pharma, you name it — but we also have some of the worst outcomes," Jaime Dimon, CEO of JP Morgan, said in an interview with CNBC at the World Economic Forum in Davos, Switzerland, earlier this year. "Obesity, wellness programs that could work better, the opioid problem, 40 million uninsured. So you know, to me, you look at the whole issue and what should we do about it."
It’s a competitive issue for the United States, Dimon adds, saying "that is a huge impediment to American business over the next 50 years.”
Which makes Defining Value—The Foundation Of Outcomes-Based Risk-Sharing Agreements published in Health Affairs this week a compelling and insightful perspective. The path to health system innovation has almost almost nothing to do with the infinite means and functional capabilities of new technologies added to obsolete operating models, but everything to do with aligning perspectives on shared marketspace.
Outcomes are the keystone concept to converge perspectives.
It’s the story at a system level that becomes the locus for innovation and creativity. It’s about making novel linkages and new combinations to form the “foundational partnerships around which we can help bring the health system—or, at least, our part of it—into alignment,” say the authors (Susan Shiff, Senior Vice President and head of the Center for Observational and Real World (CORE) for Merck; and Curt Medeiros, President of Optum Life Sciences).
“No matter our roles in the health care system, we are all striving for the same result: high-quality, high-value patient care. Yet, in a complex, constantly evolving system with so many players, making value-based care a reality is challenging. New ways of thinking and operating are required to bring a value-based system to fruition.”
Value innovation flows from a different mindset. This has less to do with using “digital” to personalize promotion and push the technical merits of a product in isolation from its environment, than it does mastering and marketing system level change.
“Our work is not remotely close to done,” concluded Medeiros and Shiff. “But we’re closing in on the first—and, perhaps, most important—goal: mutual understanding.”
Which can only come from new words to think new thoughts.