Rotman Management

Fighting Fragmentation in Healthcare: A Modest Proposal

GIVEN ITS COMBINED IMPACT on economic development and human health, few would argue that the healthcare sector is the most important industry in the world. Together, the annual economic impact of the hospital, healthcare professional, assisted living and commercial sectors totals multiple trillions of dollars, accounting for more than 10 per cent of global gross domestic product. In the U.S., Canada and other countries, the sector is the number one or number two employer, and it is marked by ongoing innovation: Seven of Fast Company’s top 25 innovators in 2018 — Apple, Amazon, CVS, AliveCor, Novartis, OneOme and Peloton — have active health or healthcare programs that, among many others, are helping to grow economies around the world.

Looking beyond economic impact, healthcare in almost all countries has made amazing progress in the past 50 years in terms of helping people stay healthy, solving major health problems, reducing infant mortality and contributing to longer lives. World Bank data, for instance, reports that from 1960 to 2016, average life expectancy at birth in the world increased from 52.6 to 72.0 years, while average infant mortality fell from 121.9 to 30.5 deaths per 1,000 live births.

Although there is huge variance within and across countries, the trends in almost all countries show at least moderate gains. Innovations and diffusion of drugs, devices, clinical procedures, fitness programs, and many other facets of health and healthcare products and services — introduced by traditional healthcare firms and by a vast range of new ventures and diversifying entrants — underlie these improvements.

Despite all of this, we are far from realizing the potential benefits of even our existing healthcare knowledge — let alone the and others highlight major shortcomings in equity, efficiency and health outcomes throughout the world. Individuals and organizations in the sector often struggle to achieve the ‘triple goal’ that thoughtful stakeholders in all healthcare systems aim to achieve: To provide services with a strong combination of quality and innovation, to as many people as possible, at an appropriate cost. If we are to achieve this triple aim, we need disruptive changes.

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