Healthcare IT Tipping Point?

Robert Seliger is the president and CEO of Sentillion Inc., Andover, Mass. Contact him at robert.seliger@
sentillion.com.

Several years ago, a friend and former McKinsey consultant recommended that I read what was then a new book, “The Tipping Point: How Little Things Can Make a Big Difference,” by Malcolm Gladwell. I eventually purchased the book, thinking that it would be yet another in a long litany of feel-good business books. Instead, what I discovered was a treatise that has had as much impact on me today as Hesse’s “Siddhartha,” Salinger’s “The Catcher in the Rye” and Vonnegut’s “Slaughterhouse-Five” did when I was a teen-ager.

“Tipping Point” is not a business book, at least not in so many words. Instead, it is a wonderful assessment of how the seemingly magic forces in society, technology and world events can conspire to result in almost spontaneous change, much as a rush of cold air stream and warm waters can come together to almost instantly produce a storm on an otherwise perfect day. An example of a tipping point is the suddenly steep decline in the crime rate in New York City after rampant growth in the 1980s and early 1990s. An example of a tipping point that has not yet come is teen-age smoking, which continues unchecked despite substantial societal and governmental effort to stem the tide.

“Tipping Point” … is a wonderful assessment of how the seemingly magic forces in society, technology and world events can conspire to result in almost spontaneous change.

While Gladwell does not prescribe how one can create a tipping point, he does describe both the necessary ingredients and the signs for recognizing when a tipping point might be happening. These lessons, still very much with me years since reading the book, have me wondering if the healthcare information technology market is presently on the verge of a tipping point.

Key Ingredients for a Tipping Point
To understand my observation, it is necessary to first understand Gladwell’s model for a tipping point and then assess how it applies to healthcare IT. Gladwell groups the key ingredients for a tipping point into three categories:

Applying these ingredients, it is easy, in retrospect, to understand why after decades of rule, Soviet communism collapsed in the mid-1980s. Independent of one’s political beliefs, there were powerful messengers, including President Reagan, Soviet President Gorbachev and pivotal Moscow “Mayor” Boris Yeltsin. The sticky message—its spread abetted by the nascent World Wide Web—was that there were better lifestyles, livelihoods and lives outside of the Iron Curtain. And then there was the context, including a Soviet economy that was all but in ruins, driven to such a state to a large degree by the tremendous investments being made by the Soviets who were trying to keep up with the United States’ “Star Wars” missile defense program. That things tipped as mightily as they did is little surprise in retrospect.

Healthcare IT at Tipping Point?
Is healthcare IT now in the midst of its own tipping point toward pervasive and system use of information technology as the backbone of contemporary healthcare delivery processes? Certainly, with the appointment by President Bush in July 2004 of Dr. David Brailer to the unprecedented role of national coordinator for healthcare information technology, the United States now has at least a formidable and skillful “connector.” Dr. Brailer and his team have done much to get the industry thinking and talking about healthcare IT, and this topic now looms larger on our national agenda than it ever has. (It was even discussed by President Bush during the second presidential debate last year.) Other connectors, mavens and salespeople are also part of the process, from Janet Marchibroda, CEO of the eHealth Initiative, to Laura Adams, CEO of the Rhode Island Quality Institute, who have done much on the national and local levels, respectively, to effectively evangelize the importance of healthcare IT. The sticky message is an easy one: Spiraling healthcare costs need to be contained, and the frightening number of medical mistakes made in our country—errors of commission—needs to be eliminated.

Spiraling healthcare costs need to be contained, and the frightening number
of medical mistakes made in our country—errors of commission—needs
to be eliminated.

The context includes an aging baby boomer population that will not accept arcane and cumbersome paper-based systems as the basis for their healthcare. Nor do these aspiring retirees want to spend the majority of their personal savings, arguably larger than that of any other generation, on healthcare. Yet, the demand is for healthy, robust, fully lived lives well into an age when previous generations would have been considering nursing homes. And, let’s not forget the context provided by electronic connectivity via the Internet that we can all but take for granted.

I started my career in healthcare IT not long after reading “Siddhartha,” “The Catcher in the Rye” and “Slaughterhouse-Five,” and since then I cannot remember a time when more has been happening to galvanize our industry than is happening today. While healthcare IT has not yet tipped, and a tipping point could still be years away, something different, new and exciting is clearly happening. I do not know if Mr. Gladwell would classify what is happening as an epidemic yet, but having studied so many other changes in technology, society and business, I believe he would agree that we might be on to something.