Is Healthcare on the Right Path to Transformation?

Healthcare transformation is an evolving strategy. Some say a slow-but-steady approach works. Others—not so much.

Healthcare transformation is all the rage on the conference circuit these days, but are health systems and hospitals really transforming anything?

The litany of pain points within healthcare is long, from workforce shortages to soaring costs to ineffective outcomes. To address those issues, healthcare executives are looking at new technology like AI and virtual care. Some are looking for small, incremental gains, while others say the entire care delivery system has to change.

But Arthur Gianelli, MA, MBA, MPH, FACHE, chief transformation officer for New York’s Mount Sinai Health System, points out that technology may have caused just as much harm as good. For example, he says, EHRs transformed the healthcare industry “the wrong way.”

During a HealthIMPACT Forum this past week in New York City, Gianelli said the EHR is a great tool for collecting information, “but right now it has made the lives of our practitioners demonstrably worse.” Clinicians, he says, now spend as much time in front of computers as they do in front of their patients. 

As a result, the industry sees transformation as a return to the past, when patient and clinician faced each other and talked about health.

That said, technology has the potential to improve healthcare—if executives know how to use it. And that comes with practice.

“You want people to try, to experiment, to potentially fail and to try again,” he said.

What’s the fix? Call your baby ugly.

Sachin Jain, MD, MBA, FACP, thinks healthcare hasn’t done enough yet to transform—and it’ll take a lot more pain and suffering to move the industry in the right director.

Jain, president and CEO of the SCAN Group and Health Plan and a long-standing voice in the healthcare field, is critical of efforts by health systems and hospitals to enact change because, he says, they haven’t really changed anything yet.

“Why have we made changing healthcare harder than putting a man on the moon?” he asked.

In a colorful appearance by video at the HealthIMPACT Forum, Jain said the industry has “normalized the abnormal” and put the wrong people in charge of care, creating a generation of people trained not to ask the tough questions—such as, why is healthcare having such a hard time defining value-based care?

It’s a question many healthcare innovation leaders are asking as disruptors like Walmart, Walgreens, and CVS Health all struggle with their primary care strategies. The popular response to this has been “Healthcare is hard,” but why is it hard? Have years and years of pay-for-procedure and episodic healthcare clouded the playing field so much that healthcare executives can’t understand what constitutes value?

Jain argued that healthcare leaders have to get serious about change, to the point of shutting down programs that aren’t working and enduring declining revenues and job losses. But healthcare, he said, has a very hard time shutting down anything.

“You can’t change without changing,” he said. “It starts by calling our baby ugly, and that’s really, really hard to do because it’s our baby.”

Jain likens AI to the printing press in its potential to transform an industry but says healthcare leaders have to ask the tough questions now, cutting programs and positions that aren’t working.

“When people talk about workforce strategies, a lot of times it’s because you have a [horrible] workforce,” he said, using a NSFW phrase.

To Gianelli, that means moving away from the same old conversations about financial benefits and looking more closely at what healthcare should be doing: Making people healthier. AI could do that, he says, and it could also “change the types of people that we actually need in the organization.”

He described transformation as a culture, rather than a strategy, and said healthcare organizations need to enact change not in the boardroom, but on the floor. That means pulling nurses, doctors, and patients into the conversation.

“Clinicians in a hospital attach to purpose,” he said, emphasizing the idea that everyone needs to be on the same page to enact change.

Jain said that will be tough.

“We’ve eroded people’s purpose,” Jain added. “And we’ve tried to solve the problem by giving doctors tchotchkes on recognition day.”