When new digital technologies and data-driven systems are introduced in the healthcare industry, they are often referred to as "disruptors" or a "disruption." These terms can get thrown around pretty frequently in conversations about healthcare innovation, but it can often be unclear — to patients and hospital executives alike — what the term actually means.
Here, 12 prominent healthcare innovation leaders define what disruption in the context of healthcare means to them.
Editor's note: Responses have been lightly edited for clarity and length.
David Shulkin, MD, president of Shulkin Solutions and former secretary of the U.S. Department of Veterans Affairs: There are many ways to disrupt something. I look for six features. Disruption can have any one of the six and often has more than one characteristic. They are: a noticeable change in the business model, rethinking how an outcome can be achieved, a new entrant into the customer-producer relationship that results in doing something different, a significant change in the process in how an outcome can be achieved, eliminating a key component of a process or part of a system, and redefinition of a problem and a solution.
Chris Coburn, chief innovation officer of Mass General Brigham (Boston): To me disruptive innovation, classically defined by Clay Christensen, means fracturing an established market and enabling new participants to enter. The new entrant may initially compete on a single element — such as price, impact, convenience — but in the Christensen model, the goal is to dominate. In healthcare, the disruption should ultimately result in improved health and will likely include at least one of the following: enhanced efficiency; more effectively treating or curing a disease; reduced cost of a service; expanded access; [and] accelerating a treatment or diagnosing an illness at a stage, price or mode previously impossible or at least impractical.
Daniel Durand, MD, chief innovation officer of LifeBridge Health (Baltimore): Disruption is what occurs when the status quo within an industry is forced to rapidly and spontaneously reorganize in response to a novel stimulus. The stimulus could be something endogenous to healthcare, such as an innovative new care model or medical technology, or exogenous to healthcare, such as a global pandemic or political unrest. Across industries, 2020 has arguably been the most disruptive year in over a century, and healthcare is rapidly reorganizing in ways that few of us would have thought possible in response to a number of exogenous and endogenous stimuli. If it feels chaotic, trust me — it's not just you. The job of leaders in times like these is to make sense of the chaos and steer their respective organizations through the storm of rapid change into a brighter and better future.
Rose Ritts, PhD, executive vice president and chief innovation officer of Jefferson Health and Thomas Jefferson University (Philadelphia): Disruption is a challenge to implicit and underlying assumptions — often driven by the training of a profession's dominant groups — about the nature of the task at hand.
Andrew Rosenberg, MD, chief information officer of Michigan Medicine (Ann Arbor): Disruption is any change in the methods by which an organization and its members harness new methods of work based on novel technologies and use of data. When aligned to specific business goals, these can dramatically change the way work is accomplished including automation, and relief from less valuable use of time and resources.
This process is often idiosyncratic to the organization since health systems invest differently in people, processes and technologies; so "disruption" for one institution may not be the same for another. This is why the rare disruptor that is broadly applicable across organizations is so important to recognize and adopt.
Disruptors should be recognized for their value to disparate employees even if there is some effort to adopt. Disruptive technologies, services and information methods should be immediately identified as valuable and even provide a sense of joy and awe in their use.
Sven Gierlinger, chief experience officer of Northwell Health (New Hyde Park, N.Y.): In most cases, disruption is a forced-upon change derived from external influences — oftentimes, the term can take on a negative connotation. In healthcare, we are constantly pivoting to best address disruption whether it be policy, procedure and/or consumerism-based standards. It's how you react to disruption that will ultimately define if and how your organization will succeed.
For example, airline, banking and hospitality industries have completely restructured how they interface with their consumers, within a digital capacity, to meet evolving needs. At Northwell, the COVID crisis forced us to hyper-accelerate many strategies which were already in flight, such as telehealth and digital health communication tools. As healthcare leaders, we remain flexible and forward-thinking to not only react to disruption, but use it as impetus for meaningful change, innovation and inspiration.
Aaron Martin, executive vice president and chief digital officer of Providence (Renton, Wash.): Disruption is a competing business model that puts the existing incumbent model at a disadvantage. It typically delivers more value to the ends of the value chain — either the source of value creation (physicians/clinicians) or end consumer (patients) of value being created in the chain.
Eduardo Conrado, executive vice president and chief strategy and innovation officer, Ascension Health (St. Louis): It's important to differentiate between innovation and disruption. There are many innovative tools coming into the healthcare space to improve the delivery of care for the patients and communities we are privileged to serve. We need to be innovative in finding or creating these solutions to anticipate and respond to the needs of patients, but also key is our ability to scale innovations quickly across our entire health ministry. That's when disruption happens and can truly help us in sustaining and improving the health of individuals and communities.
Lisa Sershen, chief digital officer of Westmed Medical Group (Purchase, N.Y.): Disruption, to me, is the introduction of any novel innovation to an industry that sparks change, enhances efficiency and has the potential to make a profound impact on the lives of others. With respect to healthcare technology, we're seeing a lot of disruption in the form of artificial intelligence being integrated into care delivery and advanced EMR systems that help healthcare providers to improve on care delivery. These innovations share the ultimate goal of creating better health outcomes for individual patients in the communities in which they live.
Disruption has the power to break down barriers, especially for health tech vendors — new entrants into the market often have a unique ability to displace previous technologies that become obsolete, creating new markets and meeting uncovered demand. I think the companies who will succeed in this environment are those who partner with the disruptors, embrace change and explore new ways to continuously improve our healthcare models.
Claus Jensen, PhD, chief digital officer and chief technology officer, Memorial Sloan Kettering Cancer Center (New York City): Disruption should be a force of positive change in healthcare. With new tools and technologies, we have an unprecedented opportunity to help more people with more things. To us, disruption is not about becoming something different, rather it is about always pushing toward a better model of care.
One of the things that I love about working in healthcare is that it is not a zero-sum game. Every time we improve tools, processes, standards of care or our understanding of disease, we have an outsized positive impact on many people's lives.
Nicole Cable, chief experience officer, InnovaCare Health (White Plains, N.Y.): The term disruption is something that can happen without warning. It occurs when the use of ineffective or inefficient processes are upended and a smarter, customer-centric, simpler and cost-effective solution to a problem impacts the market for the better — it adds benefit.
Jean Mixer, chief digital transformation officer and vice president of strategy of Boston Children's Hospital: Digital disruption is when an innovative business model or service enabled by technology outperforms historic models typically beginning with simpler services and with success, moves its way up to more complex services.
A recent example is telehealth. Telehealth began with relatively simple urgent care visits. In the wake of COVID-19, this was rapidly expanded to more complex care like neurology and complex behavioral health. At Boston Children's, outpatient virtual visits grew from 1 percent of outpatient visits to 85 percent in the four weeks of March, and in the wake of ongoing social distancing remains at almost 50 percent of visits.