Closing One Chapter on Digital Health…and Opening Another

July 2, 2021
A reflection on Malcom Gladwell’s sage keynote from over seven years ago and how pioneering industry innovators have created great hope for the future of digital health transformation

Over the past few days I have been reflecting on my early days covering the health IT industry, specifically rereading one of the very first blogs I wrote early in 2014. At the time, I was reporting on an event that featured a keynote from the always astute Malcolm Gladwell, who of course isn’t a healthcare expert, but still was able to use his vast world knowledge to apply some important lessons learned to our sector. 

Gladwell noted that the data interoperability challenge in healthcare was more than just getting technologies to talk to each other; rather, the real questions stakeholders ought to be asking are around culture, framing, and consequence, he said at the time.

In his talk, Gladwell, the author of five New York Times bestsellers, offered one specific analogy from the digital music industry revolution. He recounted that the MP3 player, which first came along in 1998, marked the beginning of converting music to digital form. By 2007, Apple had sold 100 million iPods, and out of the digitization of so much music came musical interoperability, said Gladwell. “Before the digital music age, music was a prison to the device from which it was played. Now, you have complete interoperability and far greater consequences than anyone imagined—no one predicted this revolution,” he said.

And despite people in the music industry pessimistically framing the transformation of their sector, Gladwell noted that in reality, the impact of digitalization was positively incredible. During the first decade of the 21st century, revenue from live music performances actually tripled, he reported. “The industry found out that consumers didn’t want to spend hours of browsing in record stores, but instead wanted one or two songs rather than the whole album. They wanted to spend their money on a real, live experience with a musician or band they loved," he said. 

In that speech over seven years ago, Gladwell also talked about the great importance of culture in the context of innovation, referencing the Bekaa Valley Turkey Shoot, an incident in the Lebanon War of I982, when the Israelis shot down all 87 Syrian fighter jets within two days while only losing one of their own, which was due to accident, not Syrian attack. The key to the Israelis’ success was interoperable warfare technology, using drones, precision guided missiles, and airborne warning and control system (AWACS) planes to coordinate in real time and keep the Syrians guessing and off-guard, Gladwell described.

But the core point he made, and what was especially impressive, was that the Israelis didn’t invent any of these tools, instead relying on the concept that digital technology could work well when synergized. In fact, it was the Soviets who were deep thinkers and the Americans who had the resources for new technology. But it was the Israelis, despite not having the brainpower, wealth, resources, or knowhow, who went out and learned how to put these pieces together and make them speak to each other, he explained. 

“After a period of soul-searching, the [Israelis] had a sense of urgency,” said Gladwell. And in his talk, Gladwell so wisely emphasized, “Nothing of any real value will happen unless you are all convinced that we have a genuine crisis.”

Well, we don’t have to look any further than the COVID-19 pandemic to see the impact of digital health transformation. This crisis reiterated the significance of digitization in just about everything we do, but much more significantly so in healthcare. Just a sprinkling of those digital health innovations over the past year and a half include:

  • The “new normal” of care delivery rapidly shifted to virtual and at home, with some health systems experiencing up to 500 percent growth in their number of virtual visits, obviously fueled by the government’s stay-at-home orders.
  • Trying to stay out in front of an infectious disease that was evolving by the day, industry leaders ramped up their use of data analytics and artificial intelligence (AI) to analyze trends, monitor patient populations and inform decision making that impacts patient care.  In addition to using these gained insights to figure out when hospitals would most need resources to meet the surge of COVID cases, patient care leaders were facing another, parallel issue: the number of people who were delaying other care, not related to the virus, was also increasing at alarming rates. To that end, one leading-edge case study highlighting the importance of AI and analytics involved Community Health Network in Indiana leveraging AI to identify patients who were on a trajectory to becoming high-risk by accounting for social determinants of health (SDOH) and lifestyle factors to reveal hidden patient risk.
  • As the crisis twisted and turned all throughout 2020 and into 2021, so did consumers’ needs and expectations. For health systems, it became imminent for them to enhance the patient experience as it arguably never mattered more. A major part of any consumer-driven strategy is being data-driven and digitally focused. “Digital front doors” have become a new buzz term, and digital health leaders are now applying lessons learned about what has worked during successive phases of the pandemic—such as using AI chatbots that give the ability to answer all sorts of different types of patient questions, and almost simulate the experience of dealing with a person.

Put altogether, even in the middle of a global pandemic, digital health venture capital (VC) funding nonetheless soared in the first half of 2020, with $6.3 billion in new investments—a 24 percent year-over-year increase, according to Rock Health. Meanwhile, Q1 2021 closed with an eye-opening $6.7 billion in U.S. digital health funding, the most-funded quarter to date. “Digital health is in a pivotal moment. Innovators, investors, and buyers are rightfully exuberant for digital health to transform discovery, care delivery, and well-being,” Rock Health senior leaders wrote in their Q1 wrap-up report.

As our Editor-in-Chief Mark Hagland succinctly put it in a recent editorial, “Over all this innovation hangs the specter of the coming healthcare cost cliff, which will be upon us all before we know it. As the Medicare actuaries keep reminding us, the annual overall costs of the U.S. healthcare system are exploding right now, from the current $3.6 trillion-ish per year, to around $6 trillion per year within six to seven years. No better burning platform could be designed for healthcare innovation than that.”

This is the reason why the integration of data and technology has become such a key component of healthcare organization initiatives today. Value-based care is driving the digital health revolution, with data-driven decisions, improved care and lower costs all going hand-in-hand—if one of the legs of that tripod falls, the completed evolution will ultimately fall short as well.

The reason I’m writing about digital health innovation now is that in my nearly nine years covering the industry, I’ve been so impressed and encouraged by the advancements that have been made, particularly in response to the unprecedented crisis that unfolded over the past 18 months.

So as I note all of these accomplishments in this piece, it’s accompanied by nostalgic feelings from the past decade, as this will be my last bylined commentary as Managing Editor of Healthcare Innovation.

My next move will be announced soon—please follow me on Twitter @RajivLeventhal—to find out more in the coming days, but in the meantime I would like to express much thanks and gratitude to my wonderful team, including Mark and our Senior Contributing Editor David Raths, who have both taught me so much along the way and who I know will keep producing excellent content and reporting as they have always done, long after I leave.

With that said, what I can say is that I’ll still be in the digital health industry, which is something that was necessary for me to make a career change. I’ve become so inspired by this field over the years, from the ongoing innovation to the new players and disruptors, to the incredible opportunities that lie ahead.

In his talk over seven years ago, Gladwell concluded, “Sometimes, when we look at innovation, we make the mistake of thinking that innovation is specific to an individual invention or a device. The greatest transformation brought about by technology is when you bring the various pieces and have them work together in combination. It’s the synergies that bring about the greatest changes in the world."

While healthcare certainly has a ways to go to reach the holy grail of what Gladwell is referring to—the industry's digital transformation is very much still in its early stages—we have all been witness to that gold rush that is clearly underway. So, I hope we can all take solace in the progress that has been made over the years—growth that should pave the way for an even more transformative future. I know I will.

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