When I started medical school, the Dean told us that 50% of what we learn would eventually be proven wrong, and that we would forget the other 50%. What he didn’t say was that over the course of our careers, the practice of medicine would incrementally and fundamentally change because of technology, and particularly because of the internet and the internet of things.
Every innovation in healthcare is disruptive to someone. And until you understand how, your innovations will never fully succeed. Disruptive innovation is scary. It’s scary for hospital administrators because budgets become less predictable, job portfolios change rapidly, and the cost of change management can far and away exceed the cost of innovation. It’s scary for doctors and nurses because we are taught to work in certain ways, we get comfortable and efficient, and like all human beings, we naturally resist change. The internet of things has led to an explosion of products that have the potential to fundamentally change how doctors and nurses approach the delivery of healthcare, and how patients’ experience it.
Uber isn’t just a newcomer to the taxi industry, its business model has redefined what a taxi is, and in a few years there won’t be taxi companies, there will just be Uber and Uber-like ride-matching services. When people talk about the “Uberization of Healthcare”, they are mostly talking about Uber’s actual business model being applied in healthcare. A patient using an app to pick and choose the best individual healthcare delivery, care team, and therapies in a convenient and informed way. The ultimate in consumerized healthcare. But the Uberization of healthcare isn’t just about choice, it is about disruptive innovation. What Topol calls the “Creative Destruction of Medicine.” It’s about taking everything we think we know about delivering quality healthcare and throwing it out the window, rebuilding processes from the ground up and embedding and embracing disruptive innovations in health technology, best practices, and new service delivery models. And to healthcare delivery organizations and, perhaps more importantly, to healthcare providers that’s more than just scary, it’s heresy. So we look for reasons to say NO. “There is NO NEED for change”, “there is NO EVIDENCE to support change”, or more paternalistically, “We KNOW what our patients need.”
The healthcare technology industry is also culpable. Many healthcare products are built on loosely defined problem statements with insufficient clinician and patient involvement. We get dozens of pitches for products that solve problems we don’t actually have, or that only partially solve real problems. The Apple Watch effectively solves the problem of “I am too lazy to take my phone out of my pocket.” It doesn’t solve the problem of “I am in the middle of a sterile procedure and a nurse is calling me and I can’t answer the phone, and I am not wearing a watch because I am doing a sterile procedure.”
At the Mackenzie Innovation Institute, we believe in transforming healthcare through disruptive innovation; tearing processes apart to understand how to make them work better and rebuilding them with “innovation by design.” So we built an Innovation Unit at Mackenzie Richmond Hill Hospital, a living laboratory in an inpatient medical ward, where we can study workflow changes that result from disruptive innovation, not just from healthcare technology but also from clinical practice changes and alternative service delivery models. We are implementing next generation smart machine technology in a real healthcare environment, to better understand clinician and patient adoption, and clinical and financial return on investment.
We are also embracing the concept of the digital moment of health. Healthcare is made up of transient moments of opportunity to improve health, or transient risk to worsen patient outcome or experience. When these clinical moments occur through digital interactions, we call them digital moments of health. By capitalizing on the flow of information at the digital moment of health, we can create complex digital interactions that enrich patient experience, and improve patient safety and quality of care. When we link healthcare devices and systems together, we create an Internet of Healthcare Things with truly boundless opportunities.
In this blog space, we will explore innovations in health technology and service delivery from the perspectives of clinicians, healthcare executives, and the healthcare industry. We will challenge convention thinking, ignite debate, and unabashedly promote change. As Ted Levitt said, “Creativity is thinking up new things. Innovation is doing new things.” Let’s do something new in healthcare. Game on.
Aviv Gladman, MASc, MD, P.Eng, FRCPC