The need to control healthcare costs and the increasing scarcity of healthcare resources are important drivers. However, there are huge impediments to the necessary changes: these include massive complexity, entrenched stakeholders, regulations and cultural inertia.
Technological advances are major disrupters. We have witnessed many examples of established industries, such as mass media, being completely disrupted. But these changes were never driven by existing players – new entrants used innovative technologies to create novel and more powerful business models that overcame the established models. But most importantly, these changes ultimately better addressed the needs of the customer.
It seems to me that the common interpretation of “Shift left” is that the existing healthcare players need to do their best to drive this change. But what incentives do they have, when shifting to the left empowers another player? What incentive does a hospital have to provide in-home devices to a patient so they don’t have to visit the hospital? Certainly increasingly there are government initiatives, but these often seem to be designed as compensation for doing things that are not in an organization’s best interest, so are unlikely to be durable or cost-effective.
Significant change to healthcare will ultimately be driven by consumers adopting technologies that will empower them and minimize their experiences as patients. The existing players will have their control reduced despite their inevitable resistance to change and the many barriers they will cite, especially existing system complexity.
We have learned that technological sophistication often allows much simpler solutions to emerge and ultimately prevail.