Disruptive innovation has been a source of growth and trepidation in the healthcare industry. The widespread adoption of EHR systems and first implementations of telemedicine have industry leaders questioning their roles in the future of healthcare—but not all disruptors are technological.
There has been a monumental shift in the focus of healthcare providers: away from treating sickness, toward promoting overall health. This is exemplified in CMS programs such as risk-based payment models, accountable care organizations, and quality measure reporting. Along with a shift in focus come new provider strategies to address individual patient and wider industry problems.
In order to alleviate accessibility problems, urgent care clinics have opened across the country in pharmacies and as freestanding facilities. Pharmacies offer seasonal vaccination clinics to address population health issues, particularly during flu season. Virtual and wearable technologies are continually making it easier for patients to take an active role in their own wellness and preventative healthcare plans.
Hospitals with the Highest All-Cause Readmission Rates
|Hospital Name||Readmission Rate||Discharges|
|Harlan ARH Hospital||21.3%||4,212|
|St. Lucie Medical Center||19.2%||12,479|
|St. John's Episcopal Hospital at South Shore||19.0%||7,004|
|Westchester General Hospital||18.9%||4,563|
|NU Health Nassau University Medical Center||18.6%||17,277|
|Larkin Community Hospital - South Miami Campus||18.3%||5,524|
|Forrest General Hospital||18.2%||26,530|
|Johns Hopkins Bayview Medical Center||18.1%||19,792|
|Presence Saint Francis Hospital||18.1%||7,633|
Fig 1 Data from Definitive Healthcare
Disruptive innovation happens when an industry seeks to provide accessible solutions to systemic problems at a low cost to consumers and providers. Rather than simply modifying and improving upon existing structures, disruptive technology directly addresses a larger issue by subverting the traditional methodology and opening up dialogue that leads to further improvement.
At New York Presbyterian/Weill Cornell Medical Center (NYPWC), hospital ER wait times drifted upwards of two hours. Soon after instituting a telehealth system in their emergency department, wait times plummeted to less than 20 minutes. In this new system, nurses assess a patient and determine whether they would be a good fit for a virtual examination by a physician in the network at a different location. This freed up on-site physicians to tend to more serious or complicated injuries. Where other facilities may have altered workflows or modified the check-in system, NYPWC instituted a completely new technology that disrupted the typical hospital ER system and improved patient experience.
Similarly, Banner Health was recently able to drastically reduce mortality rate, length of stay (LOS), and care costs by integrating telehealth into its ICUs. In-network physicians were able to treat patients remotely and share input to support on-site physicians via two-way audio/video monitors. Remote physicians were also able to monitor data trends and preemptively react to clinical events, as well as ensure that evidence-based treatments were administered properly.
Fig 2 Data from Definitive Healthcare
Mercy Health System (MHS) has also achieved results similar to Banner Health through its Virtual Care Center (MVCC). The MVCC offers telehealth support to physicians and patients in their network: 300 virtual care professionals serving 30 MHS ICUs in five states. Virtual physicians are able to track ICU patient data and trends while coaching on-site physicians and care providers in administering treatment. This has led to decreased ICU mortality, lower readmission rates, and shorter ICU LOS.
All three of these care providers have utilized telehealth to compensate for a shortage of on-site care providers. With physician shortages being considered a major concern in the next decade, virtual medicine could be a viable resource in an industry where specialists are spread thin. This technology could be particularly useful for rural care centers, as it can be difficult to transport patients to more well-equipped facilities with greater numbers of specialty care providers.
In addition to modifying how physicians communicate with one another, the role of nurses will likely shift with the popularization of telehealth.
At NYPWC, nurses in hospital ERs are responsible for taking patients vitals and assessing their candidacy for a digital consultation with a physician. For both Banner Health and MHS, nurses and physicians must be able to collaborate on a higher level than before. Digital communication often runs into barriers that don’t exist to the same degree in face-to-face interactions. Physicians will be relying more heavily on nurses in ERs and ICUs to collaborate on treating patients in an accurate and timely manner.
When using virtual medicine, there is a greater need for experienced nurses and care providers and an emphasis on critical-thinking skills. If telehealth continues to be instituted in emergency departments and ICUs, nurses will have to have strong communication and collaboration skills as well as the ability to monitor subtle patient symptoms in order to preemptively act on clinical events.
Of course, there will be challenges with integrating virtual care providers into physical work spaces. Nurses in particular are known for their ability to offer personalized, compassionate care to patients before and between physician visits. It will be a challenge to offer that same level of empathetic care through a screen from miles away. There will also be technical obstacles when incorporating remote physicians and care providers. Hospitals and care centers will have to find the best ways to include virtual providers into huddles, formal meetings, and debriefs.
If you would like to learn more about the impact of disruptive innovations on healthcare delivery, Banyan Medical Systems is hosting an annual CNO summit in Omaha, NE. Registration is free online, and attendees can earn 4 CEU credits through the Advisory Board Company.
Definitive Healthcare has the most comprehensive and up-to-date information on over 7,600 hospitals; 960 IDNs; 230,000 hospital executives, and more. Our database includes integrated data on quality care measures, CMS program participation, and financial metrics on tens of thousands of care facilities across the United States.
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