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A Shift From Disruption to Change

by Brian Eastwood | October 03, 2016

One of the most striking characteristics of the Health 2.0 conference has always been its focus on disruption. (For this we owe Clayton Christensen a debt of gratitude.)

In rapid succession, startups take the stage to present their vision for disrupting healthcare through the use of information technology that, one way or another, has already crept into every other facet of our everyday lives. In rooms filled with like-minded techies, forward-thinking healthcare organizations (HCOs), and eager investors, demoes are met with applause and an occasional question, which may or may not be directly answered. Laudably, patients are invited, encouraged to participate, and found at the tables right near the stage.

This year, the event took on a more somber tone. And while that sounds disheartening, it should mark an important shift in the way new companies address healthcare’s old problems.

Past events discussed “the unmentionables” of healthcare – topics such as sexual health, stress, and sadness that might get covered in the seventh conference room on the left at a more traditional, buttoned-up conference but are far too taboo for the main stage.

This year, that conversation shifted to “the unacceptables” – hunger, the opioid crisis, violence, suicide, and other issues critical to ensuring that the many disparities defining healthcare in the United States no longer go ignored.

At least, the conversation started to shift. While some demos focused on pressing healthcare needs such as musculoskeletal pain treatment (Simple Therapy) or chronic condition management (Omada Health and Welkin Health), most stuck to the familiar script of “Facebook for X” or “WhatsApp for Y.” (There was an “Uber for healthcare,” Veyo, but with CPR-certified drivers and vehicles equipped to handle stretchers and wheelchairs, it comes closer than most.) Data-sharing demos emphasized use cases for clinicians, which improve the care experience but still don’t yet put data in patients’ hands. A panel on new care delivery models suggested that patients haven’t shown a willingness to adopt new services, which earned a stern rebuke from Dave deBronkart – one of the many patient advocates recognized by Health 2.0 earlier in the week.

Initially, I was dismayed. I even ranted about the need to address chronic conditions on Twitter:

Then I realized something. By committed to addressing the unacceptables, the focus of Health 2.0 moved from disruption to change. And with this maturation comes the requisite growing pains:

  • Disruption is a hodgepodge of effective but disconnected point solutions. Change is a hegemony, if not a harmony.
  • Disruption is pilot projects. Change is full-scale implementation.
  • Disruption occurs around the edges. Change permeates an organization.
  • Disruption removes technical barriers to data sharing. Change removes cultural and political barriers.
  • Disruption happens quickly, almost overnight. Change takes decades, if not centuries.[1]
  • Disruption engages healthy millennials with smartwatches. Change engages their at-risk parents.
  • Disruption is talk. Change is action.

Even after 10 years, big-name vendors remain notably absent from Health 2.0. This despite the continued presence of numerous government leaders who clearly value the message of the event and the vision of its attendees. While this stems in part from healthcare’s parallel innovation paths, with large vendors and small vendors each addressing separate issues, Chilmark Research reckons that much of it boils down to the former seeing little value in interacting with the latter – or, disappointingly, in interacting with the patients, members, and consumers that small vendors view not just as end users but as partners in the development process.

It’s easy to dismiss disruptors as boorish, idealistic, and impatient. (Especially when they challenge your fundamental business model.) In a lot of cases, there’s no harm in being dismissive. Many disruptors burn out; many more fade away. As it turns out, the world doesn’t need several online pet food retailers.

But some disruptors achieve systemic change – and when they do, the act of dismissing them becomes boorish, abrasive, and shortsighted. The taxi industry, in its fight against more convenient, less expensive ride-sharing services, has gained few allies. Health IT vendors that fail to see the changing forest for the disruptive trees risk doing the same thing.


[1] Consider the persistence of bleeding as a treatment for just about every bodily ailment well into the 19th century despite a growing body of scientific evidence to the contrary. Or, on the contrary, consider the far-reaching consequences of the industry’s well-funded but poor-planned implementation of EHR systems.

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