We really shouldn’t be surprised. But, collectively, we always are. Change comes slowly, creeping up like a shadow, and then all at once it’s everywhere. Molds, paradigms and businesses are all eventually shattered, broken to make way for the next great thing.
Along the way the real innovators figure out how to break themselves as they grow their business in a kind of adaptive, malleable model which always improves, always moves forward and always has something new to offer. Those who do not get replaced with the kind of velocity that will make your head spin.
In this information age in which one can really learn anything on a whim, we really should be better at predicting major shifts. After all, the Sears to the Willis Tower transition came swiftly. Mobile computing became the default within the same decade of its creation. Are we really surprised that the internet has changed daily life for almost all?
Of course not, and in nearly all cases, the invisible hand, a concept first described by Adam Smith in 1776 in “The Wealth of Nations,” drives this rapid pace of change constantly toward something better and often creatively destroying outdated systems. That’s the point. It’s invisible – at least at first. But after enough of its work has been made manifest, its fingerprints are everywhere.
That is what I was thinking about as I walked the showroom floor at HIMSS last year: Adam Smith, an invisible hand, and creative destruction. How could I not? All around me, literally in every booth, was AI, AI, AI.
Apparently everyone has it now. If that is the case, this must be the most explosive technological revolution in the history of humanity. I mean, from one year to the next, every major and minor IT provider in the U.S. healthcare market has become an expert in AI driven solutions. Or….as Ray Dalio puts it so simply in “Principles,” is “this just another one of those?”
Specifically, is AI another interoperability, enterprise imaging, deconstructed PACS, patient portal…(the list of past technological fads is exhausting, isn’t it)? Each were and are great ideas, but those which have also either fallen short of what was believed to be achievable or simply didn’t catch on in a real, system changing manner. It begs the question by contrast, is there something about today which is truly different?
The last time an opportunity or shift of this apparent size occurred was 2009 with the implementation of HITECH in February of that year. The U.S. government created a source of funding to incentivize the adoption of electronic health records. That was different.
Famously, Judy Fulkner had created Epic Systems in 1979 and electronic record keeping had been around since well before then, but in this case, things had truly shifted and there were many vendors in that space ready to make their run at the new paradigm of that decade. February of ‘09 was full of “shifts,” as one might recall, with the stock market bottoming less than a month following HITECH (not that the two are directly related), and the EHR and stock market have been off to the races ever since.
Perhaps infamously, due to the outsized success – and its catalyst – relative to her competitors, Judy recently found herself the subject of a rather popular presentation on regulatory capture from Bill Gurley (a venture capitalist and central figure in Showtime’s “Super Pumped”). I suppose that story continues to unfold as the success Epic achieved within this technological era is inarguable.
So if our time is truly different as it was in the era of “The Big Short,” then something else, an incumbent of some kind, has to step aside to make room. After all, budgets are only so big and each day presents us with the same 86,400 seconds. For every vendor to be able to do it and/or every health system to consume it, what was once a production process or product has to be broken, destroyed like paper charts used in the first decade of this millennium or all the other hopeful EHR vendors laid waste in the wake that is Epic Systems. So with respect to production, enterprise use of artificial intelligence in healthcare…what gets wasted?
As vendors and technologists, we spend so much time presenting and demonstrating what has been made, I don’t think sufficient time is spent contemplating what gets broken in the process.
From Aidoc’s perspective, we certainly have needed to pivot and break from our original conceptions of what AI in healthcare was going to be about – what was going to be its most important contributions, functions and lessons. Mostly, as you can see from the list below, what needed the most corrective adjustment was our own perspectives. Here are some of those aspects of ourselves and our customers we were forced to address if the potential of our field was to ever materialize:
In fact, here is a list of the kind of out of the box capabilities the aiOS™ accomplishes for an enterprise:
We took the steps to create this kind of environment because it was necessary. There was no alternative system/software/platform which could accomplish the above. Had we found one, it would certainly have been faster/easier to leverage the creativity of others to our advantage. When what one needs isn’t available from others, there is only one other avenue to pursue – build it.
Through this process of creation, we learned that what needed to be broken and destroyed first was our original notions, assumptions and beliefs regarding what the future of healthcare looks like, what it will require, and who will be its deliverer.
Through the much lamented, layered bureaucracies of healthcare, ours is a clear and direct path through the sea of marketing and trade show aspirations, in which everyone is an expert, to the material, actual benefit designed and directed to your next patient. It’s real, and it works.
We are honored and humbled by the 1,200+ global medical centers which have already joined Aidoc on this journey of learning into our future. At the same time, we are equally excited for the new relationships being established concurrent to this writing. Provided we are all continuing to break what’s not helpful and adapt to what is, it’s going to be a brighter, safer and more productive tomorrow.
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