Written with Jonathan Bush, CEO, athenahealth
In Part 1, we laid out the failings of Healthcare 1.0 and 2.0 that have primed us for the renaissance that is Health 3.0. While there have been many failings of the 1.0 and 2.0 era, there are also positive and necessary elements that must be brought forward. It’s hard to argue that it’s not an especially challenging time for nearly anyone in healthcare. We have epidemic levels of burnout amongst doctors, only 20 percent of physicians report being engaged, healthcare organizations are struggling to keep up with every-changing reimbursement and quality rules, and government, while well-intentioned continues to inadvertently stall rapid-pace innovation. Without a common vision and framework of what a new health ecosystem (3.0) should look like, we’ll remain where we are, failing to activate the full potential from our collective passion, resources and efforts. Even eight Olympic-caliber rowers can’t make headway without a common goal and view of the course ahead.
In the next generation Health 3.0, the fragmented, uncoordinated healthcare jumble we know today must be replaced with a unified interplay of these four key elements –
- Health & wellness services
- The purchasing practice of health & wellness services
- The technology used across the many workflows and corners of healthcare
- The role of government
Healthcare is frequently a jumble of uncoordinated silos organized around medical technology, rather than people. This has led to a sub-optimal experience for both patients and clinicians. This is only made worse by by incentives that, too often, run counter to optimizing health outcomes.
As part of the Health 3.0 framework there will be top-level implications for the following audiences
Audience | Health 3.0 Implications |
Healthcare provider organizations | There are major trends that make healthcare 3.0 a once-in-a-career opportunity (or threat). Experts expect $1 trillion of annual revenue to shift from one set of healthcare players to another over the next decade. This a byproduct of the transition to purchasing healthcare with accountability baked in.
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Technology startups | Innovate with the Like-Minded – Where’s that Puck Going?
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Government officials | With Health 3.0, government will experience implications within the many roles it plays:.
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In future pieces, we’ll expand on items highlighted in the schematic above. For example, there are several references to transparency. True transparency is far more than simple pricing information. In follow-on pieces we’re working on, we will outline a vision for how local, state and federal governments can enable the highest performing health ecosystem. While federal policies get the most attention, the old adage of all health being local is true in many respects. It’s been said that zip code is a better predictor of health than DNA code. Healthcare 1.0 and 2.0 were all about the less than 1% of one’s life spent inside of a clinic or hospital. Health 3.0 explicitly prioritizes the “other” 99% of one’s life.
Health 3.0 is an exciting world where hospital CEOs aren’t put in the conflicted position of being rewarded as though they were a hotel GM trying to fill beds. Health is in the community and health systems can rejoice that there is finally a set of financial incentives that are aligned with their missions. Unfortunately, perverse incentives have put hospital CEOs in an untenable position where their mission said one thing and the financial incentives directed them to do exactly the opposite.
The great news is that there are many hospital CEOs who are just as excited about Health 3.0 as the hundreds of thousands of clinicians in the “tribe” that convenes on the ZDoggMD Facebook page and in the real world. Naturally, they also need a path forward. To that end, while 3.0 is the vision, Dave and Leonard Kish curated a set of guiding principles for success in the new 3.0 health ecosystem. It pulls together insight from dozens of leading thinkers on the future of healthcare. For example, Jonathan expanded on the guiding principle Monopolies On Medical Knowledge And Information Are Unethical.
Make no mistake, the endeavor to transition to Health 3.0 is the defining struggle of our generation. Healthcare 1.0 and 2.0 have had hugely negative consequences:
- A 20-year long economic depression for the middle class is a direct byproduct of an under-performing healthcare system. This has resulted in the most unique presidential election in our lifetimes;
- We have epidemic levels of burnout amongst doctors as a result of the over-correction from Healthcare 1.0 which had its own shortcomings;
- The largest generation in history and the largest chunk of the workforce, millennials, are on a path to indentured servitude to the healthcare industry if we don’t change our course.
Successful struggles in our past such as civil rights were driven by grassroots movements. Whether it was civil rights, climate change, or improved food, media and film played a catalyzing role. It’s not hard to imagine that if MLK was alive today, you’d find him using the tools of the day whether it was YouTube, Facebook livecasts or satirical films. The following are examples of how media and film are being used in the Health 3.0 movement:
- Earlier this year, ZDoggMD, wrote and performed EHR State of Mind (watched over 1 million times on Facebook and YouTube) that was an anthem to let doctors be doctors and move beyond today’s stifling electronic health records that, too often, has turned doctors into glorified billing clerks;
- Earlier this week, ZDoggMD launched an anthem to unbreak healthcare with Lose Yourself (video embedded below). He plays the role of an Attending Physician guiding his interns and residents to not lose themselves in the morass of Healthcare 2.0. Rather, he calls them to be leaders in the movement to Health 3.0;
- Dave is the Executive Producer and Jonathan is a contributor to The Big Heist that will be the Super Size Me/An Inconvenient Truth/The Big Short of healthcare. We have been assembling a world class film-making team behind some of the iconic TV shows and films of our generation to create this satirical, follow-the-money film. We realize the only way to reach the broad general public is to be highly entertaining in a non-partisan manner. We will highlight the collateral damage from Healthcare 1.0 and 2.0 while highlighting the leaders already living the Health 3.0 vision.
[Disclosure: ZDoggMD is creatively involved with The Big Heist, a satirical follow-the-money film in the spirit of Super Size Me and The Big Short that Dave is producing.]
We believe this is an opportunity for all of us to be on the right side of history for the biggest challenge of our generation. We realize all of us have contributed, whether we knew it or not, to the wildly under-performing status quo. Now it is time for us to collectively unbreak healthcare.
To that end we’ll share our view of the path forward in future pieces. We invite you to weigh in as it will take all our wisdom and energy to make this happen. Stay tuned for more details to be filled in.