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Healthcare innovation won't come to those who wait


Brian Eastwood, Senior EditorLast week, as I listened to the State of the Union address and read story after story about the fallout from King v Burwell, the ups and downs of Medicaid expansion and the fate of the Affordable Care Act, I thought back to a healthcare innovation event at the Massachusetts Institute of Technology I attended a little more than a year ago. 

Camden Coalition of Healthcare Providers founder Jeffrey Brenner, M.D., said then that healthcare faces its "Blockbuster Video moment." The industry can continue to provide customers with the same services as the world changes, Brenner was saying, or it can get with the program. 

I remembered this event, and its theme of "Netflix-like disruption," as my headline put it, amid a very busy week for healthcare in the United States. Instead of innovation, though, I got to thinking about the stagnation that all too often gets in the way.

Innovation comes slowly to healthcare. On the face of it, this makes sense. My failures--sentences that make no sense--don't hurt anybody. (Except, perhaps, my journalism professors.) Healthcare's failures--ineffective treatments, drugs with dangerous side effects, complicated reimbursement models--do hurt. Sometimes, they kill.

Unfortunately, there's a consequence to a slow rate of change. Electroshock therapy, narcotics and even leeches played a prominent role in medicine decades longer than they reasonably should have. Today, it's the system itself that needs a dose of innovation--and it's a dose that few seem ready to step up and administer.

Last week proved that healthcare reform is, indeed, stagnant. We're waiting for March 4, when the Supreme Court hears King v Burwell. We're waiting for June, when the Court makes its ruling. We're waiting for the fall, when state and federal legislatures will start to come to terms with the impact of the ruling. We're waiting for the 2016 election, when American voters will decide which brand of reform they prefer.

We're waiting for Godot.

It's time for the industry to stop waiting and start doing. This weekend, former President Bill Clinton, speaking at an event in Palm Springs, California, called for a "grassroots" approach to improving healthcare. Frankly, it's exactly what the industry needs.

Providers, payers and patients all have a role to play in this process. At a simple level, patients must take better care of themselves, providers must help patients take care of themselves and payers must make sure patients can afford to take care of themselves as their providers see fit.

Obviously, it's more complicated than that--but not in a bad way. Patients can encourage each other. Providers can learn from each other. Payers can use the information they have about patients and affiliated providers to start conversations about more effective, less costly care options, such as pay-for-performance programs that reimburse physicians more for helping patients in greater need.

When we talk about healthcare innovation, it's easy to get caught up in buzzwords. Digital health. Big data analytics. Population health management. Wellness. (Heck, I suppose "Blockbuster Video moment" and "Netflix-like disruption" probably count as buzzwords, too.) It's also easy to get caught up in politics and policy, especially given the rhetoric in capitol buildings around the country.

The real change won't happen in the halls of Congress, and it won't emphasize buzzwords. Instead, it will happen in the halls of hospitals, forward-thinking insurance companies and homes of all shapes and sizes, and it will emphasize the habits that help all of us get--and stay--healthy.

Then, finally, we may see Godot arrive. --Brian (@Brian_Eastwood and @HealthPayer)

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