Issue link: https://beckershealthcare.uberflip.com/i/961245
176 THOUGHT LEADERSHIP HSS CEO Lou Shapiro: 'Disruption' is a good word By Lou Shapiro, President and CEO of Hospital for Special Surgery H ealthcare is constantly at the forefront of today's news cycle. A recent Wall Street Journal arti- cle discussed the future of hospitals and a shi from the traditional inpatient, full-service hospital to ambulatory sur- gery centers, outpatient clinics and mi- crohospitals, while an op-ed in e New York Times questioned if the hospital was obsolete. Obsolete is a strong word. Where I am – at HSS – we are a healthcare or- ganization that includes a hospital (the New York City-based Hospital for Spe- cial Surgery). e hospital is not obso- lete; it is a very important part of the healthcare system and offers a broad array of services. We are seeing new examples of tra- ditional players blurring the lines in healthcare, with mergers like CVS and Aetna, and UnitedHealth and DaVita making top headlines. Organizations outside of the healthcare industry are also becoming players, with the collaboration between Am- azon, JPMorgan Chase and Berkshire Hathaway front and center. Addition- ally, there is the previously announced Health Transformation Alliance – two groups of employers 'taking the bull by the horns' and working to change how healthcare is delivered. With all of this going on, there is con- stant talk that the healthcare system is broken. It's not 'broken'. Every day, millions of people receive care, with lives being saved or improved. Re- searchers and providers constantly de- velop new knowledge to help improve care, allowing the industry to do things we never thought possible. e healthcare system is not broken. It is complicated. Too complicated. And it certainly can be made better. Much better. With all of this in mind, the key word to focus on in 2018 and beyond is dis- ruption. Words that begin with 'dis' are typically construed as negative, but in this case, it's not negative. Disruption in the industry can contribute to pos- itive changes and impact the way we provide care, as well as the cost of that care. e industry is not structured in the way that it needs to be in order to be successful. Consolidation, blurred lines between organizations and em- ployers asserting their influence all provide an opportunity for disruption. e question is will this disruption happen from the outside-in or from the inside-out? Disruption from the outside-in will come from organizations like Amazon and Google using their technological intelligence to drive change or utilizing their size to encourage innovation. In- side-out disruption will come from his- torically separate players in the health- care industry blurring the lines between them and using their influence to change how and where healthcare can be deliv- ered, as well as how it may be paid for. en there is the continued consoli- dation of hospitals and health systems becoming bigger (and bigger). In my view, bigger isn't better. Bigger is just bigger. Better is better. Finally, there are those organizations that have the potential to make signif- icant contributions to disruption by le- veraging their quality, value and knowl- edge. Let's use the organization I work at as an example. HSS is a leader in the field when it comes to musculoskeletal health. Other organizations have sim- ilar knowledge and expertise in other areas of medicine. We have a responsi- bility to either contribute to disruption from the inside-out on our own, or to partner with an another organization to cause disruption, which can make a real difference in providing affordable and effective care, and a stronger healthcare industry. n