Healthcare has long fallen victim to hyperbolic rhetoric. We casually declare it to be “broken” when evidence to the contrary can be found in every hospital and clinic. Others say that any day now, Amazon or another big tech player is going to either rescue or destroy us, when neither is likely. And it has become a well-worn trope to call for outside “disruption” when open-minded collaboration among health system leaders, providers, and tech entrepreneurs can yield more lasting value.
As a physician and CEO of a health tech company, and a writer-anthropologist who’s spent years observing this space, we think it’s time we put these tired narratives to rest and expand our thinking. Rather than fixate on the “what” — the next big thing, trend, or government rule that will save or squash us — we should instead focus on why we need to change and identify the barriers that stand in the way. Having defined the barriers clearly — the mindsets and mechanisms holding us back — we can get to the business of solving them with a responsible approach to innovation.
To paint a picture of what responsible healthcare innovation might look like and how it can create enduring value for all stakeholders, we reached out to industry leaders for perspectives from a variety of critical vantage points. From our conversations some key considerations and principles emerged.
Understand, and solve for, the right problem
Hemant Taneja, CEO and managing director of General Catalyst (founder-investor in the company Zenooz leads) believes that to build enduring value in any industry, especially healthcare, we must reject the “false choice” between growth and good. “What that breaks down into as a framework is thinking about all the stakeholders that are relevant to your business. It means respecting people’s privacy, prioritizing equity and diversity, inclusive prosperity, and sustainability.” With this framework guiding investment and business decisions, he argues, we can then seek to align interests and solve real-world problems.
As the CEO of Chicago-based RUSH Health, one of the leading academic health systems in the country, Omar Lateef, MD has no shortage of problems to solve. For him, innovation is responsible when it is solving the right problem. “Right now, the environment in healthcare is very challenging. People are stressed. We have a labor crisis. We need people to do the work that needs to get done. The mistake that I have seen is you get very attracted by the shiny penny. And it may be that you just don’t need a penny right now.”
Rather than focus on selling the next shiny penny, tech companies should instead listen with humility, understand root causes, and tailor solutions to serve needs — even if that involves more modest enhancements to existing systems. As Lateef puts it, “everybody has a new platform, a new tool, a new something.” But health systems have made a lot of investments already and many are struggling to manage existing priorities with depleted resources. Without proper alignment, Lateef says, “we are not going to solve the challenges and the problems that we need to solve.”
Create change through “collaborative advantage”
Responsible innovation demands the opposite of a rip-and-replace approach to change, argues Taneja. “We can’t as technologists have a mindset that we’re going to go and disrupt healthcare and build a brand-new system. This is too big a problem. It’s beyond any single company. And so we have to build an ecosystem.”
Dr. Marc Harrison, an accomplished pediatric intensivist and the former president and CEO of Intermountain Health who recently joined General Catalyst, has witnessed this first-hand, including how so-called “outside experts” often miss the mark in their approach to provider organizations. “Some of the tech players can certainly come off arrogant with a disruptive ‘fix all’ approach to health systems, while some providers can be equally arrogant to assume we can ‘do tech’ without the benefit of tech leaders. Both stakeholders need each other to create the best possible outcomes for the system and the people it is meant to serve.”
The remedy to this unproductive stand-off, Taneja proposes “radical collaboration,” where investors, tech entrepreneurs, health system leaders and providers come together to solve problems with shared interests and a healthy dose of humility. At its best, such a partnership can achieve what Rosabeth Moss Kantor defined nearly thirty years ago as collaborative advantage, in which each partner benefits from the perspectives and skills the other brings to the table. Such alliances, as Kantor pointed out, yield more than just ROI; they create net new value.
At Intermountain, Harrison saw how this type of collaboration could move the needle on a problem as intractable as the transition to value-based care. With a spirit of radical collaboration, Intermountain and its tech partners stood-up a platform called Castell that “can take somebody who’s a really good doctor, or a really good clinical team, and prompt them to do what’s needed to manage the health of a population proactively.” The key to creating something that has not only achieved quality goals but improved provider satisfaction, he says, was engaging providers in the process. “You take really good well-intentioned providers with good leadership who want to make change, and pair them with a tech stack that takes the friction out and improves quality. That’s a beautiful thing.”
Such a spirit of radical collaboration is just as crucial among technology companies that typically see other vendors as competitors to be “boxed out” rather than as potential partners. The reason healthcare is so fragmented is because thousands of solutions are selling their own piece of the pie — which only adds more cost and disconnection. Responsible innovators in healthcare have the humility to know they can’t be a silver bullet for every single challenge. Any digital health company committed to driving enduring transformation should be prepared to put out the welcome mat to competitors and say: “If you’re innovating and bringing value to health organizations, and we already exist in the same space, we want to work with you — even if it means taking a smaller share of revenue.”
See the whole board
Unfortunately, we’ve seen again and again how otherwise desirable innovations can end up compromising ethics, outcomes, and equity: Racial and other biases that creep into our AI algorithms; clinical trials that fail to represent the diversity of populations that should benefit from discoveries; EHRs and other tools that promise efficiency but instead lead to provider burnout.
A responsible approach to innovation requires us to do better by seeing the whole board and gaming out downstream impacts. For responsible investors, Taneja says, this means asking the hard questions of portfolio companies up-front. “Every time you make a business model decision, or if you’re relying on AI to make important decisions in your business, it’s incumbent upon us as the fiduciaries to ask the questions around what perhaps might be the unintended consequences of those choices.”
At RUSH Health, whose health equity efforts were recently singled out by TIME magazine as a “blueprint for other hospitals,” Lateef has learned that a key way to see the whole board is to ensure you have the right lens. That means designing inclusive partnerships that bring a diversity of mindsets and lived experience to the table. “Whether it’s a potential technology partner or someone who’s going to fix our parking garage, we want to know who they are and what neighborhood they’re from. As an anchor network in Chicago, diversity and inclusion is core to our mission.”
Harrison argues that healthcare technology and innovation must aspire to do more than just avoid complicity; it should actively surface and eliminate biases or disparities that would otherwise remain hidden. At Intermountain, one data project designed with this intent showed that Spanish-speaking stroke patients had to wait longer for clot-busting treatment than English speakers. “When our emergency doctors and our stroke neurologists saw this, they were appalled. Using technology to identify these issues and make them transparent allows you to address them with targeted solutions. That is precisely why I’ve joined General Catalyst — to work in partnership with healthcare and tech leaders to seek to develop the solutions that ultimately allow us to deliver better care for all people.”
If there’s any upside at all to the current down market, it may be this: It’s as good a moment as any to collectively pause, take a step back, and recalibrate. A time to talk less about transformation as a buzzword and more about what we want healthcare to transform into — and how we realistically get there from here. It’s an opportunity to humbly seek allies from every corner of healthcare, turn competitors into collaborators, and make room for odd bedfellows — what Lateef pragmatically sums up as “a group of the willing.” Now is the time to gather forces to focus not on short-term wins and gains but on creating enduring long-term value for all.
Ashwini Zenooz, MD is a physician and the chief executive officer of Commure.
John Fox, PhD is the co-founder and co-principal of Slipstream, reporting on the biggest health issues of our times.