Healthcare's next big disruptors

Becker's asked C-suite executives from hospitals and health systems across the U.S. to share the biggest disruptors in healthcare.

The 68 executives featured in this article are all speaking at the Becker's Healthcare 15th Annual Meeting on April 28 - May 1, 2025, at the Hyatt Regency in Chicago.

To learn more about this event, click here.

If you would like to join as a speaker or a reviewer, contact Mariah Muhammad at mmuhammad@beckershealthcare.com or agendateam@beckershealthcare.com. 

For more information on sponsorship opportunities or vendor access-only badges, contact Jessica Cole at jcole@beckershealthcare.com.

As part of an ongoing series, Becker's is talking to healthcare leaders who will speak at our conference. The following are answers from our speakers at the event.

Question: Looking ahead five years, what do you see as the biggest disruptors in healthcare, and how is your organization preparing to respond?

Shelly Schorer. CFO of California Division at CommonSpirit Health (Chicago): In the next five years, I anticipate significant disruptions in the healthcare sector due to advancements in pharmaceuticals, such as breakthroughs in weight loss medication and the introduction of Crexont for Parkinson's disease. Additionally, the entry and exit of players like Amazon and Walmart, the retirement of the Baby Boomer generation impacting Medicare and inpatient care, and the regulatory changes following the November election will all play a crucial role. 

The cost dynamics of weight loss medication may shift, affecting pharmaceutical expenses but potentially reducing costs for other weight-related conditions. Crexont holds promise for enhancing the quality of life for Parkinson's patients. The industry will witness new entrants, some successful and others not. The aging population of Boomers will strain Medicare and healthcare capacity in certain regions. 

Anticipated regulatory changes post-election will influence healthcare operations. The looming recession may alter how individuals access healthcare and treatment based on affordability. Despite these headwinds and challenges, at CommonSpirit we are prepared to pivot and meet the changing needs of our communities by accurately predicting and addressing their healthcare needs efficiently.

Craig Kent, MD. CEO of UVA Health; Executive Vice President of Health Affairs at University of Virginia (Charlottesville): Like many, I have watched with interest as new entrants have joined the healthcare landscape by offering patient care in different settings and through new models. We will continue to see evolution, expansion, and experimentation over the next several years. It is no secret: patients are actively seeking more convenient and more accessible care, and they are increasingly open to non-traditional options as new models present themselves. The next five years will bring entrance of nontraditional care providers into the market, including CVS Health, which plans to expand its primary care offerings across the country, and UnitedHealth Group, the largest employer of physicians in the nation. 

Decisions will need to be made. Do we partner, or do we compete? If we partner, how can we protect our referral networks? Will academic health systems remain the largest purveyors of complex care? How do academic health systems garner margins necessary to sustain important translational research and educational programs?

We will also see through AI and advances in technology, improvements in the way we care for our patients. Perhaps our physicians will no longer need "pajama time" or scribes. Or we will no longer need access teams to schedule our operating rooms or outpatient clinics. These innovations are exciting and could allow health systems to become more efficient for our providers and our patients alike. 

The challenge is the difficulty in predicting which new technology will be successful, and which will not. It will take a great deal of trial and error to identify the winners, and healthcare leaders will need to decide at what stage to embrace new technology. There is an advantage of being an early adopter but a cost of carrying forward new technology that is eventually not successful. Striking the right balance will be important.

With all of this, the next few years will be an exciting adventure, full of innovation but also important decisions that will face healthcare leaders across the nation. 

Roxanna Gapstur, PhD, RN. President and CEO of WellSpan Health (York, Pa.): One of the biggest disruptors in healthcare will be the increasing ability and demand for consumers to access care anywhere, anytime. Although many health systems have created options like virtual care and urgent care, there hasn't been a strong enough focus on where and how patients want or need to consume care — while ensuring the access is there 24/7. Creating a continuum of care outside hospital or clinic bricks-and-mortar that is connected, easily navigable and seamless will be crucial for the future. 

At WellSpan, we are actively preparing for this shift by leveraging people, processes and technology to reimagine how we deliver care in this continuum. Legacy areas part of the continuum include our MyWellSpan portal which provides patients with access to their care teams and health information around the clock. We have virtual capabilities across nearly every service area, and our home health teams see as many patients daily as our hospitals, with an average census of 1,400. Part of this continuum is remote patient monitoring where patients can be monitored outside a visit or hospital stay and remain in their own home. 

Additionally, our Hospital at Home program has had over 1,700 admissions, achieving excellent clinical outcomes and patient satisfaction. By focusing on this anywhere, anytime continuum of care, we are aiming to deliver affordable care anywhere, ensuring we adapt to and meet evolving consumer expectations.

David Berger, MD. CEO of SUNY Downstate Medical Center (Brooklyn, N.Y.): The disruptors in healthcare I see having a significant impact in the next five years are artificial intelligence and robotics. Robotics will be useful in alleviating care givers and hospital employees of repetitive physical tasks such as cleaning beds and bathrooms, changing linens. and transporting patients, medications, and supplies. AI will alleviate some of the burden imposed on caregivers by assisting in clinical documentation. AI will also improve the efficiency of healthcare workers engaged in back office functions. Finally, AI will assist in early disease detection, improve diagnostic accuracy, and enhance our ability to care for patients outside the hospital.

Rawle Seupaul, MD. Executive Vice President and Chief Physician Executive of Carilion Clinic (Roanoke, Va.): Biggest disruptor: Technology advancements (generative AI, machine learning, etc.) will improve healthcare delivery substantially over the next five to 10 years. Digital tools will enable patients, clinicians, and systems to improve efficiencies, expand services, improve end user engagement, and enhance the personal relationships between patients and clinicians that are at the core of everything we do.

Russ Johnson. President and CEO of LMH Health (Lawrence, Kas.): There is little doubt that the future of healthcare will be disrupted. We are heading on a trajectory that is simply not financially sustainable for both healthcare providers and the country in total. These dynamics will create the most important disruptors as we seek to solve the "math" of our delivery system. With that in mind I believe the greatest disruptors will be:

1) Employer frustration with their health plans, 

2) Financial sustainability  of employed physicians and downward pressure on their incomes, and 

3) the power and money of payers. 

At LMH health we are addressing these through structural and operational engagement with our physicians towards self-governance and clinic operations, discipline on our operating structure and costs in preparation for further reimbursement declines and partnership with provider organizations to strengthen our capacity for fair and reasonable commercial contracts.

Christine Larson, BSN, RN. Vice President of Medical Group Operations at Advocate Aurora Health Care (Downers Grove, Ill., and Milwaukee): I think one of the biggest disruptors (as well as a huge opportunity) is the emerging technology of artificial intelligence. It’s going to really disrupt traditional thinking about workflows and processes within healthcare and force us to re-evaluate what we do and how we do it. Advocate Health is responding to the emerging AI technologies by embracing the changes, acknowledging that it is becoming an integral part of what we do, and fully educating our clinicians, leaders, and others about how best to apply the technology in the most patient-centered and safest ways possible. 

We will be best positioned to understand AI as it continues to evolve, and at its basic levels, how it is influencing medical decision-making for our newest generation of clinicians being trained to incorporate AI into their care planning to safely and accurately diagnose and treat chronic and acute conditions. AI is exciting and terrifying all at once. 

Peter Banko. President and CEO of Baystate Health (Springfield, Mass.): Instead of responding, Baystate Health has the unique opportunity to be driving disruption in New England healthcare and beyond over the next five years. Bringing together the clinical quality, research, and innovation of an academic system with the access, navigation, and consumer experience of a community health system. Establishing clear ways of working, behaviors, norms, and values for a clinically-driven and physician-led enterprise to translate people, process, and strategy into action and results.

Mike Koroscik. System Vice President of Cancer Care at Main Line Health (Radnor, Pa.): Currently, we have many disruptors that are shaping the future of healthcare which is driving innovation and challenging traditional models. Specifically, in oncology, several distinct significant changes and disruptions are being addressed organizationally. First, rising incidence and spending continues to challenge our traditional model. As our population turns older and cancer rates continue to increase, we must adapt to the growing demand for diagnostics, treatments, and supportive care. In addition, advancements in diagnostics and treatments, including precision medicine, cellular therapy and immunotherapies are revolutionizing cancer detection and management. Our goal as a health system is to navigate and elevate the changes to improve outcomes and address total cost of care by elevating the primary care intersections in cancer care and disrupting the traditional continuum of care in cancer through early AI-driven screening and diagnostics to targeted therapies for improved outcomes.

Stephen DelRossi. CEO and CFO of Northern Inyo Healthcare District (Bishop, Calif.): Over the next five years, declining reimbursements, increased denials, and regulatory agencies will most likely be the biggest disruptors to healthcare. As far back as I can remember, payers have put unrealistic pressure on providers to accept lower reimbursements; there was waste, but the bulk of it has been removed from the system. If we are to assume that the access to healthcare needs to increase — it does, then we should expect fair compensation from the insurers. Along the same lines, there has been a dramatic increase in the rate of denials, especially for accounts greater than $25k, but also for lower valued claims (less than $500). Higher denial rates create rework for billing without providing additional benefits – these are unnecessary denials that are overturned at or about 95% of the time. Finally, with the rate of advancements in medical and technological fields, I am suspect that the state and federal regulatory agencies will be able to process and approve the requests in a timely manner.

Ebrahim Barkoudah, MD. System Chief and Regional Chief Medical Officer of Baystate Health (Springfield, Mass.): In my opinion, several key disruptors are set to significantly impact the healthcare landscape over the next five years, covering technological, economic, and organizational domains. One of the foremost technological disruptors is AI, promising to revolutionize diagnostics, treatment planning, and patient care by enhancing accuracy, speed, and efficiency. These technologies can analyze vast amounts of data to identify patterns and predict outcomes, enabling more personalized and effective treatments. Tools driven by artificial intelligence for diagnostics and decision support are expected to become more prevalent, aiding in early disease detection and significantly improving patient outcomes. 

Another major technological advancement is the expansion of telehealth and virtual care services, a trend accelerated by the COVID-19 pandemic. Telehealth enhances accessibility for the underserved and offers convenience for both patients and providers. As virtual care platforms evolve, they will likely integrate more sophisticated analytics to enhance population health management and evidence-based policymaking. The Internet of Medical Things involves interconnected medical devices that collect and transmit health data, improving patient monitoring, enabling remote care, and providing actionable insights for healthcare providers.

The integration of these medical devices with artificial intelligence could lead to more proactive and preventive healthcare approaches, reducing hospital admissions and improving chronic disease management. Blockchain technology, with its secure and transparent ways to manage medical records and patient data, is set to enhance data security, patient privacy, and interoperability between different healthcare systems and end-users. Decentralized health systems, facilitated by blockchain, could shift care delivery from large hospitals to more distributed settings like community health centers and patients' homes, thus improving accessibility and reducing costs. Additionally, immersive technologies such as virtual reality and augmented reality are expected to grow in use within healthcare, being employed for medical training, virtual consultations, and even virtual hospitals. These technologies have the potential to improve access to care and enhance medical education, thereby reshaping the care delivery landscape.

Ryan Nicholas, MD. Chief Quality Officer of Mercy Medical Group, CommonSpirit Health (Chicago): Within 6 years CMS's goal is to transition all eligible Medicare FFS and MediCal (Medicaid) covered individuals to a plan with a value-based component and focus on total cost of care. This represents the greatest market disruption on the near-horizon. This has prompted Mercy Medical Group to move rapidly into value-based care with focus on total cost of care and network integrity. Our Medicare Advantage population grew 24% last year and we project 28% additional growth in the next 12 months. Expanding ambulatory services and improving access for primary care services to reduce unnecessary ED utilization and shorten length of stay is our top priority.

Michael Prokopis. Vice President of Supply Chain at MD Anderson Cancer Center (Houston): The healthcare industry’s shift and accelerated integration of digital health will continue to lead among major disruptors impacting the sector. At The University of Texas MD Anderson Cancer Center, we’re focused on our mission to end cancer. From a supply chain perspective, that means supporting our providers so they can continue to deliver high-value, high-touch care. We will continue to embrace generative artificial intelligence, computer vision, and other technologies to assist in collecting and analyzing data. For example, instead of continuing to operate with limited forecasting, we can integrate strategies to create accurate demand planning and enable rolling forecasting. With rolling forecasting, we can look ahead 12 to 18 months for critical supplies. Another area we are actively following and implementing is self-distribution when we can leverage auxiliary services such as drones to route supplies, ensuring our drivers and partners transporting essential supplies avoid congested highways.

Giovanni Piedimonte, MD. Vice President of Research, Institutional Official, and Research Integrity Officer at Tulane University (New Orleans): Regrettably, the next five years may bring about a perfect storm, a convergence of three global accelerations: widespread automation, aging demographics, and growing income inequality. This could lead to a prolonged period of turbulent transition and complex macroenvironmental changes in the healthcare industry. The U.S. labor force, for instance, has been relatively stagnant since the 2010s, with a growth rate of less than 1% annually after peaking at 2.6% in the 1970s. This rate might drop to less than 0.5% in the  2030s and beyond. In this already worrisome context, the impact of automation is  expected to be felt by 80% of workers, leading to wage suppression and job loss.  

Global indicators suggest that the rapid proliferation of automation could result in  the elimination of up to 25% of current jobs, equivalent to a staggering 40 million displaced workers in the U.S. alone. This could also lead to a decline in wage  growth for many more workers, with middle- and low-income workers bearing the  brunt. Among the categories at highest risk are healthcare and administrative  support staff, i.e., the front and back end staff of every healthcare business who  perform highly repetitive tasks that AI-powered chatbots and robots can easily  replace. This displacement might rapidly deprive many workers of healthcare  benefits, increasing the already critical financial pressure on Medicaid and  healthcare systems.  

While there may not be an easy way out of this impending crisis, one thing is clear: we need to start preparing as soon as possible. In particular, it is necessary to reorganize  and requalify our workforce to limit the effects of automation. The education of future  medical and ancillary staff needs to be rapidly modified and tailored to the needs of an entirely new ecosystem populated and dominated by AI, quantum computing, robotics, telemonitoring, digital twins, wearable sensors, precision algorithms, and whatever else  the future will bring above and beyond our current imagination at unprecedented speed. 

On the receiving end, the new digitally native generations will progressively phase out inefficient doctor-patient interactions, triggering a shift to healthcare paradigms modeled on the other commercial services used in everyday life, like Netflix for entertainment, Amazon for shopping, Uber for transportation, etc. Independently of any effort made by the healthcare industry, the more global challenges posed by the progressive aging and  decreased natality of the more economically developed populations and, significantly, the  increasing income inequalities concentrating 70% of the total U.S. wealth in the hands of the top 10% of earners will bring the healthcare system to a collapse if not rapidly reversed. In other words, healthcare and society are inextricably intertwined, and fixing one without fixing the other may be impossible. 

Jeff Gautney. CIO of Rush University System for Health (Chicago): Biggest disruptor will be continued pressure to use automation to make up for the lack of available talent, particularly in care delivery. Technologies like AI, RPA and other automation tools will help, but they will create their own challenges. AI will exponentially increase cyber threats as it becomes harder and harder to build strong identity management infrastructures. RPA will multiply process changes up and downstream from the automation, leading to unintended consequences at times. The IT function of the future will have to continue to evolve to manage these technologies, and to even better understand how to leverage IT tools to improve processes.

At RUSH, we are investing in people first and foremost, on the belief that a talented and flexible workforce in IT is the number one factor in success. We are upskilling our existing team, and making strategic investments in new talent to grow our capabilities.

Karen Miller, RN, MS. Chief Quality Officer of BayCare Health Systems (Green Bay, Wis.): I see the current payment structure for healthcare in the United States as unsustainable. The move toward value based payment, advanced payment models, bundled payments has not been implemented in a successful manner. The ability to coordinate care of an individual patient, in a high quality cost efficient manner is nearly impossible to achieve given the lack of price transparency across settings and across payers. 

Our organization continues to work toward obtaining comprehensive accurate data about the cost of care a patient has received over an episode. The Centers for Medicare/Medicaid have begun to get a handle on this and provides annual information about episode costs related to some procedures, but does NOT currently provide the detail necessary for healthcare organizations and providers to be able to better guide patients and implement specific strategies to achieve cost efficiencies. Both CMS and private insurers have data that is confounded by contractual rates, uncovered services, etc., so that the true cost of associated care is not really captured. I see achieving true cost transparency as a critical next step if the United States truly hopes to address rising healthcare costs. 

Thomas Maddox, MD. Vice President of Digital Products and Innovation at BJC HealthCare (St. Louis)/Washington University School of Medicine: The rise of consumerism in healthcare will continue to increase. As such, our system is investing in improving digital and physical "front doors" to our services, better patient experiences, and support for patients along their full healthcare journey.

Angela Orth. Internal Consultant of Cone Health (Greensboro, N.C.): In the next five years, healthcare systems will continue to see the use of artificial intelligence as a major contributor and perhaps disruptor in the healthcare sector. Appropriate adoption of AI can be valuable to the health care institution and to the patient. Partnering with innovative AI companies can be a differentiator for health care institutions, which can lead to increased capacity, lower wait times, and reduced waste in the healthcare delivery model.

D. Richelle Heldwein. Chief Risk and Compliance Officer of St. John's Health (Jackson, Wyo.): As a hospital risk manager, I would be remiss if I didn’t mention the landscape of run-away jury verdicts and increases in volumes of malpractice claims. These trends contribute significantly to the costs of providing healthcare and can significantly impact the reputation of providers and hospitals. It has been difficult to get meaningful legislation to limit liability and damages, so I think that we will see an increased emphasis on early resolutions and on aggressively defending good medicine.

AI is also going to play a big role in healthcare and much of what we will see with AI can and will be a disruptor. The cost of technology and the potential expectation that AI will set a new “Standard of Care” for healthcare providers is a real potential and will need to be addressed not only from the standpoint of what and how to implement, but how to pay for implementation. Our hospital has piloted a program for a virtual assistant in every doctor’s appointment and that virtual assistant “listening in” and then composing the H&P, Chief Complaint, Symptoms, and Plan of Care into a chart note in the EMR software. This has huge potential for time saving for providers, improved accuracy in quoting patient responses, and also potential for new kinds of errors in not only documentation but in treatment.

And last but not least on my list is the heavy burden of compliance with regulations, both for CMS care and quality as well as billing, coding, privacy, security and overall operations. As the laws, regulations, and standards become more and more burdensome, the number of people that healthcare organizations have to hire to know the regs, audit compliance, and implement change will continue to increase. This is not only an increased financial burden for the organization, but an increased potential for fines and loss. 

Ask the organization that has experienced a cyber-attack, how costly their downtime was as well as how costly their fines and reputation impact was and they will tell you that it is not sustainable. We are working hard to not only streamline our process for internal audits, but move to annual external audits to stay continually in compliance. We are also purchasing more and more cyber insurance with monitoring resources to help prevent, recognize and curtail any potential attempt to breach our system’s firewalls. And we are focusing lots of effort in staff education on safe online practices.

Anita Harris-Brown, DNP, RN. Vice President of IS Clinical Applications and Chief Nursing Informatics Officer of Information Services at Cincinnati Children's Hospital: Technology is indeed a key driver of innovation and transformation in healthcare, especially in the wake of the COVID-19 pandemic. However, technology alone is not enough to improve patient outcomes and reduce costs. It also requires a cultural shift, a strong leadership vision, and a collaborative ecosystem that leverages the strengths of different stakeholders. Some of the biggest disruptors in healthcare in the next five years are:

1. Artificial intelligence and machine learning: These technologies have the potential to significantly enhance human capabilities, automate processes, and derive insights from vast and complex data sets. They can also enable personalized and precision medicine, and improve diagnosis, prognosis, and treatment. However, it's important to acknowledge that they also present ethical, legal, and social challenges, such as data privacy, algorithmic bias, and human oversight. Therefore, it's crucial to develop AI systems that are trustworthy and responsible and adhere to the principles of fairness, accountability, transparency, and explainability.

2. Telehealth and virtual care: These modalities have the potential to significantly improve access, convenience, and quality of care, particularly for rural and underserved populations. They can also reduce unnecessary visits, hospitalizations, and readmissions, and enhance patient engagement and satisfaction. However, their successful implementation requires a robust infrastructure, interoperability, and cybersecurity, as well as regulatory and reimbursement frameworks that support their adoption and integration. Therefore, it's important to create seamless and secure digital platforms that connect patients, providers, and payers across the continuum of care.

3. Genomics and biotechnology: These fields can revolutionize healthcare by unlocking the secrets of the human genome and enabling novel therapies and interventions. They can also facilitate disease prevention, detection, and management and enhance drug discovery and development. However, they also raise ethical, legal, and social issues, such as data ownership, consent, and governance, as well as potential risks of misuse, abuse, and unintended consequences. Therefore, it is vital to establish clear and consistent standards and guidelines that protect the rights and interests of individuals and communities.

Our organization is preparing to respond to these disruptors by investing in research and development, fostering a culture of innovation and learning, and building strategic partnerships and alliances with other players in the healthcare ecosystem. We are also embracing digital transformation and agile methodologies, as well as cultivating a diverse and inclusive workforce that can adapt to the changing needs and expectations of our customers and stakeholders.

Doug Koekkoek, MD. Chief Physician and Clinical Executive of PeaceHealth (Vancouver, Wash.): There are two disruptors in healthcare that will broadly impact delivery systems and the patients we serve. First, is the tightening payer-provider relationships (including employment) which will together manage the  premium dollar. Those payer-provider entities can be expected to disrupt traditional referral pathways and instead move care to the lowest cost site-of-service in each market, resulting in both increased competition between delivery systems and potentially fragmented previously integrated delivery models. 

Second, is the growing deficits in key acute care specialty physicians, including anesthesia, interventional radiology, urology, gastroenterology, etc. Those gaps will be filled with increased use of APCs, ancillary staff that can act as physician extenders, virtual care platforms, and "Project Echo" models of specialty collaboration, all of which can disrupt traditional specialist-patient relationships. PeaceHealth will be strategic in both areas to maintain optimal patient outcomes and experiences. 

The opportunity to selectively work with those payers that will use EMR integration and collaborative models of care management will ensure no disruption in care coordination. Ongoing efforts to keep our overhead costs down will preserve our position as a 'high value — lower cost' provider in our markets, should ensure our inclusion in narrowed payer networks. Building acute care specialty practices that are cohesive and have minimal turnover and utilizing patient-facing technology to build continuity and ensure coordination will help mitigate fractionated specialty care. Additionally, the ongoing use of E-consult services for patients will help preserve the specialist-patient relationship.

J.R. Greene. Founder and Vice Chair of PMC Board of Director at Psychiatric Medical Care (Brentwood, Tenn.): We see virtual care and AI as the biggest disruptors to mental health treatment. Psychiatric Medical Care is exploring how AI could be utilized in ways that would allow our providers to spend more time with patients and less time completing paperwork and administrative tasks. We are expanding our telehealth services to ensure that we can meet the growing demand for virtual care. This includes investing in secure, user-friendly platforms and training our clinicians to deliver effective care in a virtual environment. We are also exploring hybrid models of care that combine in-person and virtual visits to offer a more comprehensive approach.

George Cybulski, MD, Clinical Leader in Artificial Intelligence and Neurosurgeon, Humboldt Park Health (Chicago): The biggest disrupter to healthcare in the next five years is the effect of implementation of artificial intelligence. Artificial intelligence will affect every area of healthcare from clinical care to so-called back office operations of billing, collecting, human resources — specifically recruiting for positions at all levels of healthcare organizations and finally and most promising handling the mass of red tape associated with regulations. At Humboldt Park Health we have begun the AI journey with a clinical process improvement project. This experience will allow creation of a critical mass of onsight experts to assist with projects in other areas of patient care and operations.

Johanna Vidal-Phelan, MD. Clinical Assistant Professor of Pediatrics of UPMC Children's Hospital of Pittsburgh;Chief Medical Officer of Quality and Pediatrics at UPMC Health Plan: Looking ahead five years, I envision the biggest disruptors in healthcare, from a clinical and patient perspective, to be the rise of personalized medicine, advancements in genomics, and the integration of smart technology into patient care. These innovations promise to revolutionize treatment protocols, enhance patient engagement, and improve outcomes.

Personally, I believe UPMC is excellently positioned to navigate these changes. By harnessing new technology, we foster innovation in care and services, while continuing to provide high-quality, affordable care to the communities we serve. Moreover, UPMC Health Plan's dedication to health equity, clinical and payment innovations, and comprehensive health insurance and benefit management services are in sync with the expected shifts towards value-based care and personalized patient experiences.

Disruption is not just a challenge, but a significant opportunity to transform our business models for growth and success. By embracing innovation, we can stay at the forefront of the rapidly evolving healthcare landscape, helping to ensure we meet and exceed the needs of our patients, members, and communities.

Darian Eletto. Chief Clinical Officer of Bergen New Bridge Medical Center (Paramus, N.J.): I think the biggest disruptor in healthcare is the focus on healthcare and early intervention.

Since the pandemic began, we have seen a significant increase in the severity of the conditions patients are in when arriving in the emergency department during a mental health crisis. This has resulted in longer stays in our inpatient units because of the length of time it takes to reach stabilization. Admissions to involuntary units have also dramatically increased, wait times to receive care have grown longer, and we continue to face an unmet need for more mental health professionals. 

The mental health crisis is not going away anytime soon so we must find a way to help our consumers as quickly as possible. At Bergen New Bridge Medical Center, we are focused on both community outreach and expedited access to care. By going into communities, we are able to meet consumers where they are and take a preventative approach to their mental healthcare. We share the support and treatment options available to them in the hopes we can avert a future mental health crisis. 

We also are able to educate the community on the first signs of mental health challenges, so right when a change is noticed, care can be provided. Having multiple levels of care in one facility allows for our patients to receive all of their mental health and medical care in one place, decreasing the stress of finding a specialist and creating a trusting and therapeutic relationship that encourages patients and families to return.

John Mallia. Interim CFO of Arnot Health (Elmira, N.Y.): The next generation of healthcare consumers are demanding a better patient experience. Competition from tech companies and retailers will increasingly peel off patients and change referral patterns from traditional providers. Not all the entrants will stay in, as we have seen already, but those that will are the ones who will tap into the demand for access, experience, value, and perhaps most of all, convenience. Investment in digital patient platforms is only a piece of the puzzle. At Arnot Health, we are investing in people and workflow redesign as well as end-to-end technology to increase patient "stickiness" by delivering an enhanced patient experience throughout the care continuum. This includes minimizing the time to appointment and expediting patient throughput at our sites of care, creating safe and welcoming physical environments, ensuring prompt and focused clinical follow up, and implementing a seamless and fully integrated revenue cycle.

Vikram Kashyap, MD. Frederik Meijer Endowed Chair, Meijer Heart and Vascular Institute and Vice President, Cardiovascular Health of Corewell Health (Grand Rapids and Southfield, Mich.): There are a couple of significant changes in the cardiovascular space that we are navigating currently. 

1. We are moving more of our care to an ambulatory setting. We are in the midst of constructing a Cardiovascular ASC and are planning to move some of our coronary, electrophysiological, and vascular procedures to this venue and offload the inpatient arenas. This will lead to more efficient, less costly care in selected patients who may have a better experience.  

2.  Value-based care in the cardiovascular space has the potential to decrease the cost curve for cohorts of patients. We are working with our insurance arm to look at value propositions in selected patient groups including heart failure, chronic angina, and claudication patients. 

3. The potential for AI related products is tremendously exciting. I am piloting a product that listens to the ambient conversation of an office visit and then constructs a beautifully crafted visit note that requires minimal revision. Personally, this has saved me a lot of time and I can imagine that this will become a great satisfaction for many clinicians who are overburdened with documentation challenges that lead to burnout.

Ara Feinstein, MD. Physician Executive of Banner University Medical Group, Trauma Surgeon of Banner University Medical Center - Phoenix; Associate Dean of Clinical Affairs at University of Arizona College of Medicine – Phoenix: One of the most significant challenges currently confronting the healthcare sector is the shortage of physicians. In response to this, Banner Health is proactively assessing the clinical services that are affected and devising strategic solutions for the future. Recognizing the distinct nature of each specialty, we are employing a multifaceted approach that includes bolstering our recruitment and retention initiatives, expanding our residency and fellowship programs, and embracing a team-based care model with the integration of advanced practice providers.

Laura Duncan. Vice President of Ambulatory and Home Health Operations at Cincinnati Children's: The biggest disruptors in healthcare are our younger families, such as millennial and gen z families navigating pediatric care. They expect personalized and attentive care driven by digital tools with extreme convenience. We are becoming our own replacement, interrupting our traditional care models to reflect the expectations of our families. Whether through adopting a digital first mindset or expanding self-directed care options, we are readying ourselves for the new future of patient and caregiver centric care delivery!

Carman Ciervo. Chief Physician Executive of Cooper Health System (Camden, N.J.): Five years out I see the biggest disruptor being providing care close to the patient in a way that meets the patient’s needs. For example, Hospital at Home. Our organization has a robust population health team that is partnering with patients to enable this to happen. 

Another important disruptor will be the effect that GLP-1 agents have long term on patients.  Decreased muscle mass will likely lead to fractures at a younger age.

Our organization has a model whereby APNs can educate on this issue to discuss muscle strengthening as well as video education.

Tonya Jackman Hampton, EdD. Executive and Chief Human Resources Officer of UC San Diego: I see the careful implementation of AI-based innovations as potentially one of the biggest disruptors in healthcare. UC San Diego Health is evaluating AI and safely and methodically advancing the technology to benefit the experiences of our employees and patients. We are doing so with a commitment to transparency while also helping to shape national best practices.

Nygel Williams. Executive Director of Physical Therapy Program at the Washington University School of Medicine: AI is poised to revolutionize physical therapy, offering new tools to streamline processes and potentially improve outcomes. The heart of our practice lies in the therapist-patient relationship. We believe that the most effective care will come from a synergistic approach. By merging technology with human intuition, we can optimize patient outcomes.

Sidney H. Raymond, MD. Chief Medical Officer of Ochsner Health Network (New Orleans): In the next five years AI will define the disruptors. The disruption will be in how we deliver care. Many of the current tasks will become more automated and people will be able to work at a higher level. AI will also bring about more personalization in care as it will be able to take numerous data points and assist in bringing forward more relevant interventions for the individual patient. We will start to witness true tailoring of care plans for the individual.

Zeshan Anwar, MD. System Chief Hospital Medicine of Guthrie (Sayre, Pa.): The future biggest disrupter of the healthcare industry will be artificial intelligence. The head winds of staffing shortages, worsening inflation and down trending reimbursements will persist. All healthcare organizations will struggle to find solutions to improve their efficiency, reduce waste and be less dependent on human resources. We will see rapid penetration of AI in all aspects of healthcare operations. AI involvement will range from machine learning to improve processes, patient throughput, staff scheduling, emergency room patient volume prediction, epidemic or pandemic pre-alerts, helping physicians to scribe, disease prevention, diagnosis and treatment, diagnostics read (echocardiograms, radiology imaging etc.) to patient remote monitoring at home for both medication compliance and symptomatology capturing. It will help providers to reduce emergency room visits.

My organization has already signed up with a few advanced AI based processes e.g. remote monitoring of high fall risk patients. We are also actively reviewing multiple AI related projects e.g. AI based physician advisory service ,AI based documents review to predict expected readiness of discharge etc.

Rudy Jackson, DNP, RN. Senior Vice President and Chief Nurse Executive of UWHealth (Madison, Wis.): Nursing shortages, support services staffing challenges, increasing demands on nurses, compensation demands with decreasing reimbursement, workplace violence, and staff well-being, are just several of the challenges that burden nurses leaders everywhere. Over the next five years healthcare organizations need to leverage technology to support decreasing demands on teams. Utilizing artificial intelligence, using technology to approach staffing differently (i.e., acuity vs. workload), and utilization of ambient documentation are a few of the things being used at UW Health to address current and future challenges.

Elham Yousef, MD. Vice President and Chief Medical Office of Bayshore Medical Center, Hackensack Meridian Health (Edison, N.J.): In the next five years, several key disruptors will continue to significantly impact healthcare, to mention a few.

• Artificial intelligence, machine learning and predictive analytics will continue to revolutionize diagnostics, personalized treatment plans, patient outcomes and streamlining operations.
• Telemedicine and Remote Monitoring will continue to expand, offering more remote care options, especially in rural and underserved areas.
• Consumer-Driven healthcare will increasingly demand more control, including access to data, cost transparency, and personalized care options.
• Value-based care models will continue to change how physician's approach treatment and reimbursement.
• Automation of routine tasks, advancement in robotic technology, expansion of APP scope of practice, mental health support, remote work options and competitive compensation, will continue to grow to address the significant challenge of healthcare professional's workforce shortage.
• Healthcare policies and regulations, especially regarding data privacy, drug approvals, and healthcare access will continue to evolve.
• Cyberattacks will increase, threatening patient data and system integrity.

To respond, organizations should focus on strategies that are tailored to their specific needs and circumstances, not only to mitigate risks but also to capitalize on new opportunities. For example:

• Investment in innovation and emerging technologies.
• Investment to build robust digital health platforms, expanding telemedicine and ensuring vigorous cybersecurity infrastructure.
• Partnerships with tech companies and startups.
• Training and development of employees to adapt to new care models and technologies.
• Investment in data management, analytics and interoperability.
• Enhancing patient engagement and experience through digital tools and patient-centered care models
• Continuous monitoring of regulatory changes, advocacy, and ensuring organizational compliance.

Danielle Scheurer, MD. Chief Quality Officer of MUSC Health System (Charleston, S.C.): AI utilization in clinical and administrative processes. Our organization has put together a multidisciplinary team to thoroughly evaluate the safety and effectiveness of emerging tools, to ensure ethical and practical adoption.

Cindy Russo. President of Trumbull Regional Medical Center, Steward Health (Dallas): Truly the biggest disruptor for healthcare as well as other business sectors over the next five years is and will continue to be AI. AI also promises to be one of the biggest enhancers of healthcare technology. Unfortunately, most organizations are so focused on making ends meet and watching the bottom line that not enough attention has been placed on AI. Until there can be improvements in reimbursements that cover the cost of care this will continue to be the focus.

If we could turn our attention to the possibilities of AI and the efficiencies that can be made through automation and advancements to be had in improving care and expediting treatment perhaps it can help close some of that reimbursement gap.

Ryan Younger. Vice President of Marketing at Virtua Health (Marlton, N.J.): Though there are many disruptors in healthcare, I see consumers as the largest factor. Consumers are impacting technology investment, care models, data from adoption of wearables, role as payers, demand for personalization and privacy, equity, and so much more. At Virtua Health, consumers have been one of three strategic imperatives for at least six consecutive years. We invest in market research to understand their experiences, perceptions, values and behaviors. We will continue to evolve our Here for Good brand, an innovative delivery system and a caring culture to align a purposeful approach to build trust with consumers in response.

Chris Sacinski. Vice President of IT Applications at Advocate Health (Charlotte, N.C.): There are a couple of misconceptions that come to mind. One is that healthcare organizations are reluctant to start adopting AI technology. While that may be true for some healthcare organizations, Advocate Health and many other healthcare organizations are already embracing AI and view it as a true game changer if used appropriately. It does demand proper governance,  thoughtfulness, and controls, but if you wrap all that around an AI initiative, it can really transform a user experience and yield improvements in productivity. DAX Copilot is a great example of that for physician productivity here at Advocate Health. 

One other misconception I still periodically encounter is that Workday is still just an HCM system.  Workday has come a long way in the past few years to truly deliver an ERP platform that delivers full ERP needs at scale across HCM, Payroll, FIN, and SCM. As healthcare organizations continue to invest in their ERP transformation journey, they should keep Workday in mind as a full platform option. 

Mara Nitu, MD. Chief Medical Officer of Indiana University School of Medicine and Riley Hospital for Children, IU Health (Indianapolis): In the next five years, I believe the biggest disruptors in healthcare will center around sustainable and innovative care models. One significant disruptor will be the expansion of the "Hospital at Home" model, which offers inpatient care at home. This approach could effectively address current challenges in healthcare, such as workforce shortages and rising costs, by providing a feasible alternative that maintains care quality while containing expenses. Another critical area of disruption will be the development of strategies to reduce unnecessary and wasteful testing. Identifying the most effective solutions in this area will have a profound impact on the future of care models. Additionally, as consumerism increasingly influences medicine, patient expectations for better experiences will rise sharply. I anticipate that the most impactful disruptors will be digital solutions that enhance patient experience, likely through improved coordination of care.

To stay competitive in the evolving landscape of healthcare, our organization is proactively embracing these disruptive trends. We are currently developing and piloting models that test various innovative approaches in the three critical areas mentioned. Our goal is to identify and scale the most effective strategies, ensuring that we contribute to sustainable healthcare solutions for the future. These efforts reflect our commitment to staying at the forefront of healthcare innovation and delivering exceptional care.

Chuck Nordyke. CEO of Clarinda Regional Health Center (Iowa): I think the one thing that may help us advance the furthest, will also be the biggest disruptor…AI. Now I am not talking about scientifically backed AI, but rather TikTok AI where people will get more and more “medical advice” generated for sales rather than for advancing medicine. We are seeing it already…ionized water bottles. Everyone had them as they were supposed to alkalinize the body and cure everything…that phase lasted a few months and died out. And these videos have trusted people telling us it is the right thing to do. All AI generated. It will only get more prevalent and harder to identify as the technology improves. Our organization is educating the public on listening to professionals versus watching videos. We are even coming out with our own TikTok videos to poke fun at the difference.

Omar Hasan, MD. Chief Quality Officer of MaineHealth (Portland): It is difficult to anticipate the many changes that will occur in healthcare in five years, given the vast scope and scale of this sector. If current trends continue, I anticipate huge disruptions occurring in three key areas: 

1. Our patients will continue to find new ways to seek and consume healthcare services. We will need to continue to understand new consumer behaviors and evolve our delivery models to meet demand. We are responding by stepping up market research, iteratively designing digital healthcare solutions, and piloting programs on a smaller scale — to test and adapt design features — before scaling systemwide. 
2. Artificial intelligence will continue to impact healthcare in ways we cannot anticipate. Pharmaceutical innovation will pick up pace and have a sizable impact on overall cost of care. Administrative tasks will become easier in the near future through use of AI, which could improve efficiency of care delivery. We have convened a system-level executive committee to explore, test, and implement AI solutions, as this powerful technology matures over time. 
3. Market disruptions caused by payviders and other entrants in healthcare delivery, coupled with the increasingly unsustainable cross-subsidization of Medicare and Medicaid by commercial insurers, is forcing integrated health systems to test and launch innovative delivery solutions. We are actively monitoring these developments and exploring options for competing with such disruptors in the markets that we serve.

Tracea R. Saraliev. Board Member of Dominican Hospital Santa Cruz (Calif.); Board Member of PIH Health: The biggest disruptors in healthcare over the next five years will continue to be innovative technologies that were advanced as a result of the COVID-19 pandemic. Artificial intelligence coupled with these innovative technologies is exponentially accelerating their potential.

Three of my personal favorite technologies that are disrupting healthcare are remote patient monitoring by enabling patient care delivery in the home, genomics by developing precision and personalized medicine and robotics by augmenting health system labor supply.

During the pandemic genomics emerged as an essential public health tool to enable diagnostic testing methods, track variants and develop therapeutics and vaccines. Combining genomics and big data analytics using AI models create tailored care and treatment recommendations for various medical conditions particularly hereditary disease.

Remote patient monitoring has also gained traction along with the proliferation of telehealth and virtual care during the pandemic. AI embedded in these technologies allow care teams to triage those who can be treated via inpatient care services vs. hospital-at-home. Once at home continuously capturing patients’ bio-metrics allows the care team to intervene early if there is clinical deterioration.

Thirdly, robotics usage has emerged in efforts to mitigate margin pressures on health systems following post-pandemic labor shortages and skyrocketing labor supply costs. Traditionally robotics have been used to assist in surgery, but now robotics through AI learning can be used to transport materials in hospitals eliminating waste of motion and reducing labor costs. Robots can also clean and disinfect rooms where patient contagion is high, reducing pathogen spread and the associated costs.

Scott Jessie, MSN, MBA, RN. Chief Nursing Officer of SUNY Upstate University Hospital (Syracuse, N.Y.): The healthcare industry is always in a constant state of change and disruption. The next five years won't be any different, and in fact we may see disruption at an accelerated pace. Some key challenges and disruptions on the horizon include the growth and application of AI and machine learning, ongoing workforce shortages, and access to care. Developing expertise and governance in AI and machine learning will be critical as we implement these technologies to improve care while making the patient and staff experience better. Ensuring top of license practice for all roles, implementing innovative care teams and models, and focusing on retention of all roles can help combat the workforce challenges. Enhancing primary and ambulatory care, expanding telemedicine, remote patient monitoring, and hospital at home programs will be key to improving and expanding access. Overall, investment in technology, people, and services through innovative and proactive leadership will be essential as we face a rapidly changing landscape.

William Morice II, MD, PhD. President and CEO of Mayo Collaborative / Mayo Clinic Laboratories (Rochester, Minn.): Looking even five years into the future seems like a difficult task these days. That said, over that period, I expect healthcare consumerism, the overwhelming volume of health-related data that will be collected, and the migration of care outside traditional settings — which will weave the previous elements together — to be major disruptors in our industry. To address these disruptors, we are focusing on transparency to ensure that patients and the physicians who treat them trust the information they are given, understanding new sources of health data and integrating and streamlining it to make it actionable, and adapting our services to meet the growing demand for care outside the lab or physician setting. By staying ahead of these trends, we will enhance the quality of care while remaining agile in an evolving healthcare landscape.

Mary Jo Williamson. Chief Administrative Officer of Mayo Collaborative Services/Mayo Clinic Laboratories (Rochester, Minn.): From my perspective as the chief administrative officer of a diagnostics company, the biggest disruptors in healthcare over the next five years will be advancements in technology—particularly AI and other innovative tools—and ongoing regulatory changes.

Our organization is actively monitoring these areas to ensure we continue to deliver the highest quality test results for both patients and the physicians who care for them. As technology evolves, it will bring significant changes that we need to integrate effectively. Additionally, staying agile with regulatory changes is essential. We have to be quick to adapt to new regulations while continuing to provide the best possible answers that inform care.

As we provide connections to innovative tests and services, we are uniquely positioned to bring together advancements in diagnostics, ensuring a seamless and integrated approach that enhances patient outcomes and supports the evolving healthcare ecosystem.

Shreyas Mallur, MD. Associate Chief Medical Officer of El Camino Health (Mountain View, Calif.): In my opinion, the first disruptor to healthcare will be the adoption of artificial intelligence into all aspects of healthcare. First, AI will likely be used for non-clinical tasks, administrative tasks, and routine tasks. More importantly, AI will start becoming more prevalent in clinical workflows. This I believe will be a major change in how we practice medicine. 

Predictive analytics using AI will become more prevalent as we gain more confidence in the algorithms and validate the results. Organizations have to develop robust data governance around AI as well as making sure that strict controls are in place before deploying AI tools. El Camino has set up a structure having an AI governance committee to anticipate challenges while deploying AI.

The second disruptor will likely be more widespread adoption of remote monitoring and moving care outside of hospital walls. Wearables and remote monitoring technology will need to be integrated into meaningful ways into clinical workflows to really impact patient outcomes. El Camino has set up an innovation steering committee as well to evaluate remote technologies which are likely to be useful in affecting patient outcomes.

Monica N. Wharton. Executive Vice President and COO of Methodist Le Bonheur Healthcare (Memphis, TN):  We are proactively addressing the disruptors impacting the industry, with workforce shortages emerging as the most pressing challenge. According to the American Hospital Association, 100,000 RNs left the workforce during COVID and there has been a 3.3 percent decline in the  nursing workforce in the last two years alone. These shortages are straining the entire  healthcare ecosystem, requiring innovative solutions to ensure we continue to deliver high quality care that is accessible to anyone who needs it. 

In response, we are redesigning our care  model to embrace a team-based approach. This includes integrating licensed practical nurses and virtual nursing into our operations, which enhances efficiency and ensures continuity of care. We are also significantly enhancing our IT infrastructure. Over the next  decade, we are investing significantly to advance our digitization imperative, including upgrading our systems to ensure that our technology is robust, secure, and capable of supporting the needs of our patients, employees, and physician partners as well as the demands of modern healthcare. These strategic moves will not only address current challenges but position  Methodist Le Bonheur Healthcare for long-term success in an increasingly dynamic healthcare  environment.

Corey Cooper. CEO of Select Specialty Hospital (Fort Myers, Fla.): One of our biggest disruptors will be the preeminence and/or the importance of cybersecurity breaches. As data collection continues to be a target for nefarious operatives, our organization(s) must continue to place a major focus on prevention and tailor best practices for responsiveness to the same. Educating our employees across the enterprise on what to look for, and how to report such breaches as appropriate will help streamline processes to help mitigate daily disruptions.   

Cybersecurity breaches are inevitable. Our organizational IT/IS leaders are conducting regular table talks on how to quickly respond for business continuity and recovery and disaster recovery.  Preventative strategies include service segmentation on various platforms so infiltration can be isolated while building in redundancy for quick work around; and utilizing strategies for quick identification of clean vs infected applications.   

Next level will be incorporating AI to aid in projecting cybersecurity risks and assessment of mitigation actions.

Lewis W. Marshall Jr., MD, JD. Chief Medical Officer, Affiliate Dean and Assistant Professor of Clinical Medicine of Weill Cornell Medicine at Lincoln Hospital (Bronx, N.Y.): In the next five years I see several key disruptors. First artificial intelligence and machine learning will continue to be refined and used in more aspects of care including helping make clinical decisions. We will need to ensure that AI/ML is used in an ethical manner. This will take some thoughtful discussion. Another area is the continued expansion of telehealth, improving access for patients. Technology that can help physicians monitor patients at home such as mirrors and toilet seats that can monitor heart rate, blood pressure, blood oxygen levels and other measures that can be used to manage patients with certain conditions. This includes wearable devices that can monitor and transmit data in real-time. Robotic assisted surgery will provide more precision for surgeons and AI may perform parts of a procedure. With all the advances expected in the next 5 years we have to keep our patients in the center of all we do.  

Marshall Stephenson, BSN, RN. Vice President of Nursing at Children's Health (Dallas): The biggest disruption in healthcare is the increase in turnover we are seeing in nursing. This will continue to be a challenge as we continue to see our population grow and the demands on healthcare increase. Keeping our teams engaged and in the workforce will be a top priority. Children's Health is responding by looking at staffing to ensure safe and appropriate assignments. The safety of our staff in and around the organization is a top priority to ensure a safe environment to work.

Alon Weizer, MD. Chief Medical Officer and Senior Vice President of Mount Sinai Medical Center (Miami Beach, Fla.): Predicting disruptors in healthcare for the next year, let alone the next five years can be challenging.  Disruption in the healthcare industry works on many levels from the delivery of healthcare services, implementation of innovative technologies and treatments, and policy changes driving the transition from fee for service model to value based care. At Mount Sinai Medical Center, our entire team is focused on embracing innovative solutions in all of these areas to meet the current and future needs of our patients.  

Large corporations have attempted to disrupt the primary care space by offering convenient access to primary and urgent care. These efforts have faced challenges related to staffing and the lack of integration with other services that patients expect. Mount Sinai is investing heavily in both primary and specialty care leveraging both smaller and larger health centers in the communities we serve to provide integrated care to patients. While this is not novel, the ability to leverage telehealth, remote patient monitoring, and multimodal care and communication via the electronic medical record supports patients' health and wellbeing within their community.  

In addition, the integration with acute care services allows patients to flow between inpatient and outpatient care with optimized communication to all stakeholders. The continued evolution of home health services, hospital and emergency care at home, and augmented telehealth will continue to drive more complex care to the community. Continued effort to evolve these models and integrate them into the continuum of care will set hospitals and health systems up for future success as other disruptors enter the healthcare market.  

Innovations in therapeutics and interventions are occurring at an ever-faster pace in all specialties in health care, especially oncology. At Mount Sinai Medical Center, we are laying the groundwork to deliver this innovative and life-changing care to our community with the opening of the new Braman Comprehensive Cancer Center. From leveraging our electronic medical record to use genomic and genetic data to inform treatment decisions for our patients to embracing theranostics and bispecifics, our new Cancer Center will allow us to rapidly evolve to incorporate current and future therapies in our treatment paradigms.  

CMS and other payers are making a rapid shift both in public reporting and evolution of various risk models to focus on outcomes over process measures. A good example of this is the Medicare TEAMS model that will extend the concepts of the Comprehensive Joint Replacement model to other disease processes. This along with other risk and value based models will continue to drive integration of healthcare services and the value proposition through improving quality while reducing costs. While we are investing heavily to be successful in these models through primary care expansion and technology that will help reduce the need for acute care services, we continue to focus our culture on providing safe and high quality care to all of our patients.  

As we continue to leverage technology to make our hospital safer (central telemetry monitoring, virtual nursing), we recognize that hospital staff, nurses, physicians, and other allied health professionals dedicated to high-value patient centered care will never go out of style. Continuing to invest in our people is our best way to prepare for the future.  

Andrew Buffenbarger, EdD. Chief Compliance Officer of Kirby Medical Center (Piatt County, Ill.): Looking ahead five years, I suspect the biggest disruptors in healthcare will come from the widespread ownership changes within acute care. We’re seeing an unprecedented number of mergers and acquisitions that disrupt provider networks, create wage wars that stress recruiting and retention programs, and confuse patients. Our approach to managing the change happening within our market is to build and maintain relationships with every organization that moves into our area, while reminding patients that our independent hospital will continue to be the best place to get consistent care.

Marque Macon. Vice President and Administrator of Ambulatory Operations and Provider Services at Inova Health (Falls Church, Va.): Looking ahead five years, one of the biggest disruptors will be the continued entry of venture capitalist-backed care delivery models. Additionally, the ending of certificate of public need requirements in several states will allow for increased market competition of key services including ambulatory surgery centers and imaging. Inova Health has a robust strategy and bold capital commitment to ensure we offer clinically excellent, consumer-centric ambulatory products and integrated, regionally distributed ambulatory care assets. Work is underway to bolster our seamless system of care by expanding our primary care and specialty network, strengthening collaboration with community partners, and advancing our IT capabilities and consumer self-service options. We are confident that our efforts will allow us to continue to provide world-class care and be among the leading health systems in the nation.

Jen Moore. Vice President of Payor Relations and Payment Innovation at MaineHealth (Portland): Over the next five years, I think disruptors will be focused on site of service offerings. We know that brick and mortar sites will continue to evolve as more care is delivered virtually and in other settings of care including the home and ambulatory settings.  Disrupter organizations that offer virtual primary care, urgent care and ambulatory surgery centers will likely try to fill a void if health systems don't offer the care in alternative, cost-effective settings. Our organization will continue to evaluate the potential to evolve our offerings to meet the changing needs of the population, but it has to be done with caution as these shifts will require a significant financial investment, and acceptance of lower payments. 

Nicholas Nussbaum, MD. Director of Medical Affairs and Community Services, Adams Medical Group, Adams Health Network (Decatur, Ind.): The biggest disruptor over the next five years is likely to be an ongoing margin squeeze. Though published inflation has dropped well below its recent peak, it is still significantly above the Federal Reserve's stated target of 2%. Unfortunately, those published numbers may or may not represent economic reality, and they may or may not be symmetrically distributed throughout the economy. When looking at the "inputs" involved in healthcare (skilled labor, highly specialized equipment and/or supplies, etc.), I think it would be quite a presumption to think that we get back to 2% inflation in any of those arenas in the next few years, as those who can command higher prices will continue to do so, regardless of the industry.

Unfortunately, unlike the butcher and the baker, in healthcare our "prices" are largely works of fiction: At the end of the day, we are price takers not price makers. CMS largely sets prices, and everyone else in the industry just tinkers with both what they will take (as providers) and what they will pay (as insurers) once CMS has set their mark. Given that CMS is in no position to increase payments, and Congress is in no mood or fiscal position to do so either, healthcare is quite likely to be progressively ground between the twin millstones of inflation and centralized price fixing for at least a few more years.

As unpopular as it might be, I think the next five years are quite likely to be more about efficiency, restraint, and to be frank, surviving, and much less about trying to outdo the competition with yet another bigger, flashier, swankier building. I'm sure that many of my colleagues are going to respond with some version of "A.I." as their answer, but A.I. will only have a meaningful impact if 1) we can afford it, and 2) it increases efficiency to a degree that is greater than its cost.   

However, if it can meet those standards, it might actually provide a means of sustaining continuity more so than proving to be a disruptive force, at least over the next five years.

How are we preparing? In short, we are looking for quality over quantity when it comes to providers and staff (better productivity and better product, with less dead weight), optimizing every square inch of office space, OR space, etc., avoiding taking on new debt/leverage, and looking to maximize our market share within our existing footprint. None of those things are glamorous, but consolidation now means being positioned for opportunities in the future.

Matt Hinkle, BSN, RN. COO of Winchester (Masss.) Hospital: Advancements in technology will continue to disrupt the healthcare industry. The integration of AI and analytics will lead the way in the management and treatment of disease processes. This will allow providers to tailor treatment plans to the individual, improving high quality outcomes. Our organization is evaluating and expanding technology capabilities across our platform to enhance consumer centered care models.

Pierre Monice. President of Loyola Medicine - MacNeal Hospital (Berwyn, Ill.): I recognize that the healthcare landscape is undergoing significant transformation, and looking ahead five years, there are several key disruptors we anticipate will shape our industry.

The growing emphasis on mental health services is a critical disruptor. The rising recognition of mental health as integral to overall health necessitates that hospitals like ours expand our services in this area. We are actively developing programs to integrate mental health support within our primary care framework and collaborating with community partners to improve access and reduce stigma.

Additionally, changes in regulations and policies, particularly regarding healthcare access and reimbursement, will continue to challenge how we operate. To navigate this evolving regulatory environment, we are enhancing our advocacy efforts and engaging with policymakers to contribute to shaping a sustainable healthcare framework that benefits our community.

Mila Sprouse, EdD, MSN, RN. Vice President and Chief Nursing Officer at Virginia Mason Medical Center (Seattle): The first thing that comes to mind is technology. The advancements in technology, from virtual care to artificial intelligence, the latest medical devices and more, are ever present in our world, creating better access and augmenting the care we deliver. The human element of healthcare is more important than ever and technology actually brings us closer to our patients. 

At Virginia Mason Franciscan Health, we have embraced the power of technology for some time now. Our mission control command center gives us the data, tools and expertise to enhance the patient experience and improve outcomes like reducing patient length of stay and identifying more opportunities to accept new patient transfers. Our virtual hospital and virtual nursing program give on-site teams added support and patients another layer of care. We will continue to build on this foundation and remain open to other advancements as we look ahead. It's an exciting time to be in healthcare.

Greg Taylor, DO. Medical Director of Cooper Care Alliance (Camden, N.J.): The biggest challenge facing medicine is access to care, and I only see this growing over the next five years. Any and all innovations that allow for greater access to care at a lower cost will create the greatest disruption.  Leveraging technology to improve access to care from outside the hospital/office setting will create the largest disruption over the next five years.

We are currently offering telemedicine 7 days a week/365 days a year though a telemedicine program. Patients can self schedule these appointments online or they can be offered by anyone on the medical team. Many of these appointments are generated through our "inboxologist" program where an advanced practice provider will scan the phone and portal messages to generate appropriate appointments. The other technology that is extending care to the home is remote patient monitoring, which we are offering to patients with CHF/COPD diagnosis.

James Burroughs. Senior Vice President of Government and Community Relations and Chief Equity and Inclusion Officer at Children's Minnesota (Minneapolis): As we have seen over the last several years since the COVID-19 pandemic, the healthcare payer mix continues to change. Healthcare systems are seeing more Medicaid and Medicare patients. We also see demographics changing so we need to ensure our systems reflect the rich diversity of the patients and families we serve. At Children's Minnesota, we're implementing structural changes to ensure that DEI is at the center of everything we do and we've embedded measurable DEI goals within our strategic plan.

Seanna-Kaye Denham-Wilks, PhD. Chief Experience Officer of NYC Health + Hospitals Kings County (Brooklyn, N.Y.): Disruption is inevitable, that’s why it's important to build resilient teams who can monitor trends and respond in alignment with clearly defined principles. As much as we tend to localize what we address in our healthcare setting, global issues show up at our doorstep in New York on a regular basis. As a result, the next five years will provide evidence of how current political issues influence those in our community, as well as those we have yet to meet who will seek safety here.

Christopher Longhurst, MD. Chief Medical Officer and Chief Digital Officer and Executive Director of Jacobs Center for Health Innovation at UC San Diego Health: In the next five years, advancements in AI are poised to revolutionize healthcare by enhancing diagnostics, personalizing treatment plans, and streamlining administrative processes, particularly when coupled with remote patient monitoring. To ensure these technologies are implemented responsibly, UC San Diego Health is investing in robust ethical guidelines and governance, as well as rigorous testing protocols to maintain patient safety and data privacy. By leveraging the expertise of the Jacobs Center for Health Innovation at UC San Diego, we are prioritizing effective integration of AI tools while keeping patient outcomes at the forefront of our innovation efforts.

UC San Diego has already invested heavily in doing research and demonstrating health outcomes that implement AI responsibly.  One example is a study we published in Nature that showed a deep-learning AI surveillance tool successfully helps to reduce sepsis mortality; another published study about the first pilot of an Epic-based GenAI tool, revealed that GenAI could help reduce cognitive burden and help draft more empathetic physician-patient communication. These studies prove that patient and clinical outcomes, not just algorithms, matter. That's why local monitoring and assurance are critical to advancing health through AI. As healthcare professionals, we have an obligation to achieve these clinical benchmarks in an effort to improve quality, efficiency and patient experience.

To continue leading the way in healthcare AI, UC San Diego recently appointed Dr. Karandeep Singh as its first Chief AI Officer. Dr. Singh, a nationally recognized expert in AI and digital health, brings significant expertise to this pivotal role. As Karandeep likes to say, "we must use these tools to improve the experience of both delivering and receiving care."

Kipum Lee, PhD. Vice President of Enterprise Strategy & Innovation at University Hospitals (Cleveland): Though some have waned and even exited healthcare, retail and tech giants in general are staying if not expanding. Their current failures are likely to translate into learnings and iterations in five years. In any environment ripe for disruption, complacency among incumbents can quickly lead to irrelevancy. That is why it is important for health systems and providers that may still have an advantage to find ways to creatively collaborate with retail and tech companies today to be well positioned tomorrow. 

The same goes for telehealth and virtual care as well as pushing forward with care models that address the holistic and sustainable well-being of people. At University Hospitals, our three-pronged enterprise strategy involves leveraging existing and emerging technologies to solve high-value problems in customer and caregiver experience,  optimizing processes and magnitude of offerings to fit with growing community needs, and experimenting with new care models. Respectively, we are building the right customer experience tools and partnerships to deliver what retail and tech giants do well, integrating telehealth and virtual capabilities to augment the rising need in community health and wellness,  and testing new frameworks and approaches that are currently unconventional in healthcare.

Jonathan D. Washko. Assistant Vice President of CEMS Operations, at Northwell Health; Assistant Professor of Department of Emergency Medicine, Pre-hospital and Disaster Medicine, Zucker School of Medicine at Hofstra at Northwell Health (New Hyde Park, N.Y.): I believe at least 50% of what we do in healthcare is waste...

In the next five years, the most significant disruptor to healthcare will be the capacity challenges associated with the "silver tsunami" of baby boomers hitting the age of healthcare consumption. In this environment, coupled with lowering revenues, staffing shortages, and higher expenses,  healthcare is being forced from an abundance mindset to one of scarcity. This shift will likely cause healthcare to reconsider its operational models of care delivery on all fronts and shift from evolutionary traditional models to ones based on intelligent and intentional design that can do it better, cheaper, and faster while also doing no harm.

Solutions will require shifts to care in the home, new operational care models, and technology integration. These will allow the medicine being delivered to be effectively and efficiently optimized, vastly improving the productivity of existing and net new capacity.

Solutions being considered:

• Hospital at home
• House calls / advanced illness management programs
• Reconfiguring pre-hospital EMS services to gatekeep, navigate, and treat patients at the right place, at the right clinically appropriate timeframe, at the right quality, with the right data, and at the right cost (5R care model)
• 24x7 day-a-week medicine
• Lean manufacturing-based service operating models and concepts finally hit the healthcare industry at full strength with full potential

Vishal Bhalla. Former Senior Vice President and Chief Experience Officer: Looking ahead five years, the lack of interoperability between AI assets within healthcare organizations is poised to be a significant disruptor, in my opinion. As departments partner with different vendors to develop AI solutions, each vendor using its own framework, these assets may deliver short-term ROI but will struggle to integrate, leading to long-term inefficiencies. As AI becomes more powerful by ingesting more data, the resulting increased switching costs could lock organizations into specific vendors. To prevent this, organizations must develop a unified AI framework that ensures interoperability while also prioritizing human-centricity and aligning with their cultural and value systems. 

Steve Smith. Assistant Vice President of Clinical Enterprise Access and Operations at Inova Health System (Falls Church, Va.): One of the biggest disruptors in healthcare is meeting patients' needs for accessing our health system through self-service.

We are already preparing for this demand through ticket scheduling, and proactively looking at Epic scheduling visit types for additional online self-service capabilities. We have just recently rolled out Epic’s Hello World SMS outreach for billing concerns, and appointment / care management. In addition, we are in the process of implementing a cloud based phone system that has a digital assistant built into it. Patients will no longer need to navigate traditional phone trees, rather speak their responses to be routed to their requested destination. Included in the new phone system, will be speak to text self-service options, appointment management and RX refills automation. We anticipate to reduce call volume significantly, which will increase our teams' bandwidth and decrease burnout.