It's time to challenge the negative health care narrative.
Although many of us in health care welcome objective, informed criticism, there's a steady stream of knee-jerk reactions from technology companies and venture capitalists toward our industry — hospitals, specifically. I'd like to share my own perspective and some ideas for a more productive way forward.
First of all, I consider myself the biggest advocate for technology, innovation and a passion for continuous improvement. The same goes for most people who work in hospitals. I think I speak for all of my colleagues in health care when I say we are not stodgy, old-fashioned victims of tradition, even though that is the narrative being peddled by many outside the industry. Health care can never rest in the fight against status quo. That, I think, is where technology companies and venture capitalists have great potential to have a positive impact in our industry.
At the same time, little will be accomplished if innovators from outside health care do not fully appreciate or understand our mission and business models. My colleagues and I are open to working with partners to fix problems and improve the health of our people, but to do so, we need partners who see health care providers and the people within them for what we are.
Here are my five suggestions for technologists and venture capitalists to consider when they approach health systems or work with them.
I don't think technology companies and venture capitalists have enough appreciation for all the good in health care. Many speak to us as if they are omniscient and can offer a guiding light to providers unable to adapt on their own. That's an imbalanced perspective. Although problems and failings exist, extraordinary things occur every day at any given moment in our hospitals and other health care settings. If outsiders knew more about the latter, they'd be more effective in making an impact.
I've visited technology companies where I could drive a bus down the hall and never see a soul. That stands in stark contrast to hospitals, which are an ecosystem of humanity's highs, lows and in-betweens around the clock, every single day. Big tech can fall into the trap of thinking that if they come into hospitals with a neat piece of software or an app, all problems will be solved. That's absurd.
We see technology as a tool. Hospitals are among the most human of places, filled with people with personalities, fears, emotions, cultures, values, prejudices and behaviors. There's an entire world in hospitals that technology companies will miss if they do not pay attention. When technology companies talk about "customer experience," they are usually referring to interactions with people through the middle-man of technology. Few technologists and VCs have sat within arm's length of a customer who is vulnerable and worried about a medical prognosis. There's no app for that.
Health care is one of the most complex businesses you could possibly work in. It's fascinating when technology reps or investors ask me, "You mean you take care of patients even when they don't pay?" To which I say: "Yes. What do you think happens if we don't?"
I'm often left scratching my head, thinking of the isolated power they hold and their poor understanding of the business they are trying to improve. Some of their ideas have merit, but they would be much more effective if they spent more time educating themselves. Do yourselves a favor and spend more time on the ground in a hospital.
Many technology companies focus on the easy parts of health care — the relatively young, healthy individuals who are amenable to apps, devices and solutions. They don't fully appreciate that the bulk of health care costs are the result of chronic illness among the elderly, such as heart disease, diabetes, cancer and Alzheimer's disease. When the indirect costs of lost economic productivity are included, the total costs of chronic diseases in the US increase to $3.7 trillion — about one-fifth of our country's GDP.
I welcome technology that benefits relatively healthy 35-year-olds, but it won't make much of a dent in lowering health care costs. If a technology company is as good as it says, let's see its solutions for chronic conditions, mental health and opioid abuse.
Complaining about something takes no talent. Being critical of something takes no talent. It's how you come up with a constructive solution to the problem — yes, that takes a bit of talent. I respect people who learn about our business before jumping to premature conclusions, and I enjoy working with those who figure out how we can get better results and improve public health.
Michael Dowling is president and chief executive officer of Northwell Health, New York State’s largest health care provider and employer.
This op-ed appeared in Becker's Hospital Review.