It is Time for the Healthcare Ecosystem to Come Together as a Team of Teams

By Ann Bailey & Nicole Dillner

The healthcare industry has been the source of major developments over the past decades. Such improvements would be impossible without collaboration across a vast healthcare ecosystem. This medley of players is united in its focus on patient welfare but, in practice, tends to work towards this mission in silos – at best missing out on potential synergies, at worst failing to save lives in doing so. Healthcare will always be a team sport. But in addition to having independent high-functioning teams, it will take a functioning Team of Teams – within each healthcare organization and across the industry at large – to win in the future.

The healthcare industry has been the source of major developments over the past decades. Since 1965, health insurance coverage for Americans aged 65+ has increased from 50% to 98%1. Over 5 years, improved patient care has been behind a 21% decline in hospital-acquired conditions, leading to US$28 billion in savings2. The number of annually approved drugs from more efficient research processes has doubled over the last 10 years3. An effective vaccine for COVID-19 was developed in 10 months, rather than the average 10 years4.

Such improvements in health insurance access, patient care, and innovation would be impossible without collaboration across a vast healthcare ecosystem – from life sciences and non-traditional med-tech start-ups to traditional providers of care, payors, and public health organizations. This medley of players is united in its focus on patient welfare but, in practice, tends to work towards this mission in silos – at best missing out on potential synergies, at worst failing to save lives in doing so.

Interprofessional collaboration is crucial to successful healthcare

The disconnect between these various players becomes particularly evident in frontline care – when patients are overwhelmed by a patchwork of providers. Not only does it cause frustration and anxiety, but data show that roughly 80% of all serious medical errors in the U.S. involve miscommunication during transitions across health care settings5.

In 2010, the World Health Organization acknowledged the need for interprofessional collaboration in healthcare as an “innovative strategy6. Today it is imperative for healthcare organizations to deliver quality care faster and more efficiently and to create a work environment that delivers optimum patient outcomes and retains healthcare talent.

COVID-19 has brought unprecedented partnership, showcasing what is possible

COVID-19 was an incredible catalyst for collaboration across all industries. With healthcare systems often close to the breaking point, the pressure also broke down silos: departments within hospitals shared capacity, competing hospitals exchanged best practices, healthcare systems aggregated data to better understand high-risk patients and their needs, while pharma partnered with private universities (AstraZeneca/Oxford) and biotech companies (Pfizer/BioNTech) to develop vaccines. Fusion Cells that forged private-public partnerships and other collaborations7 brought unity across organizations that was extraordinary not only in its nature but also in its speed and resulting agility.

But collaboration at scale will need to be more sustainable

Mutual support across the industry has been the driving force in our anxious battle against COVID-19, but it did not come without a cost. After years of improvements, general patient safety has stagnated or even fallen since the beginning of the pandemic8, services had to be scaled back (e.g. ~10 million missed cancer screenings in the U.S.9), pressure on healthcare staff has become even less manageable (38% of healthcare workers reported suffering from anxiety or depression;10), and hospital operating margins have dropped further (~46% year-on-year11).

It does not take much to realize that the intensity of this crisis-mode collaboration is not sustainable, nor is such a singular focus scalable. The healthcare ecosystem needs a broader, more intentional approach to collaboration to truly transform the industry.

Traditional approaches to change fail to create a lasting impact

Looking at past, failed, efforts to grow the industry into a more unified field of players can be disheartening. The healthcare industry is doubtlessly both complicated – with many players and regulations – and complex – due to high levels of interdependencies – making quality collaboration an obstacle course, even for the most well-intentioned partners.

To cut through complexity, healthcare has traditionally addressed challenges with focused, singular initiatives, missing the big picture of how these challenges are related. Many challenges in the industry are, however, overarching issues, common for a complex system e.g., slow responses to unpredictable environmental changes, constraints from safety protocols and regulations, high power gradients, and low empowerment that limit bottom-up communication and decision making. The industry tried to solve for complicatedness, not complexity. It will take rethinking this issue-specific approach to mitigate vulnerabilities and combat known and unknown threats.

Thinking needs to shift from high-performing teams to working as a ‘Team of Teams'

Healthcare will always be a team sport. But in addition to having independent high-functioning teams, it will take a functioning Team of Teams – within each healthcare organization and across the industry at large – to win in the future.

The industry needs to address how organizations fundamentally operate: How does communication and collaboration happen across natural fault lines? Between residents and attendings in a unit, between hospital and payer, between pharma R&D leads and university department heads? Who are the key influencers in the organizational network who bridge silos, enjoy trust across levels, and/or offer strategic guidance? It is time to bid farewell to short-term solutions and focus on winning together long-term (Way to Work in 2022 Playbook).

A team of teams stands out through:

  • Common purpose: united under the mission of patient care and overall consumer health, organizations need to ensure strategic alignment within and across entities, particularly as organizations merge and form partnerships across the diversifying industry (Case study).
  • Shared consciousness: digitalization, data synthesis, and AI will be key to unlocking large-scale information sharing. But communication on a day-to-day basis will be just as important, ensuring shared knowledge or knowledge transfer in case of turnover.
  • Trust: healthcare organizations need to build trust between individuals and teams as well as patients, families, and communities that transcends the diversity of stakeholders, power dynamics and competing agendas.
  • Empowerment: as a highly regulated industry with an imperative on safety, empowerment to the lowest possible level of decision making – rather than traditional escalation – can facilitate faster, more agile decision making and execution in healthcare.

Operating as a Team of Teams can address top industry challenges

Healthcare has no shortage of challenges, many of which are internal inefficiencies. However, these internal challenges or vulnerabilities are exacerbated in the light of external threats, such as new diseases or industry disruptors. A few overarching industry trends include:

  • Digitalization: Automated processes, digital data management, and electronic health records are becoming imperative to managing the administrative complexities as well as advancing scientific research. It is the foundation for partnerships and new technologies but also exposes companies to the risk of cyberattacks.
  • Changing Landscape: Digitalization has been the entry ticket into healthcare for both big tech Big Tech12 and small start-ups13. But the ecosystem is also changing through continuing market consolidation of payors, providers, and retail.
  • Payments: Value-Based care is changing the payment and incentive system across the industry, meeting consumer demands for better patient care and encouraging non-traditional methods of care delivery.
  • Workforce retention: Talent shortages are an age-old issue in the industry, particularly in nursing and medical staff, with Diversity, Equity and Inclusion (D,E &I) becoming an increasing priority.
  • Equity: Beyond internal D, E & I challenges, closing data gaps increasingly lay bare a significant inequity in health care delivery, demanding a stronger focus on social determinants of health14.

Now is the time to come together as a Team of Teams

The pandemic has impressively shown what incredible feats the healthcare industry is capable of if it breaks down its silos. The pandemic has also shown what is at stake if the industry does not pull together to collaborate.

While the current pattern of survival-focused collaboration is not sustainable, it has created a striking case for change. Now is the time to be proactive, build on crisis-generated momentum, and establish a robust approach for future challenges.

Where traditional, problem-specific approaches have failed time and again, a change in how healthcare organizations operate more generally has the potential for genuine transformation. A team of teams, fueled by common purpose, shared consciousness, trust, and empowerment can equip healthcare organizations to improve both efficiency and effectiveness while strengthening their position to face future threats and disruption.


CITATIONS

[1] https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_fund_report_2015_apr_1812_davis_medicare_50_years_coverage_care.pdf

[2] https://www.fiercehealthcare.com/healthcare/five-year-decline-hospital-acquired-conditions-leads-to-28b-savings

[3] https://www-statista-com.iclibezp1.cc.ic.ac.uk/statistics/817534/annual-novel-drug-approvals-by-cder/

[4] https://www.medicalnewstoday.com/articles/how-did-we-develop-a-covid-19-vaccine-so-quickly#Funding-for-COVID-19-vaccine-research

[5] https://onlinehealth.wfu.edu/blog/silos-in-healthcare/

[6] http://apps.who.int/iris/bitstream/handle/10665/70185/WHO_HRH_HPN_10.3_eng.pdf;jsessionid=079566997A61845D589CA7367AE21919?sequence=1

[7] https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0225

[8] https://info.pressganey.com/e-books-research/how-to-bounce-back-after-covid-19s-safety-declines

[9] https://www.webmd.com/cancer/news/20210505/nearly-10-million-cancer-screenings-missed-during-pandemic

[10] https://www.ama-assn.org/practice-management/physician-health/half-health-workers-report-burnout-amid-covid-19

[11] https://www.kaufmanhall.com/sites/default/files/2021-02/national-hospital-flash-report_feb.-2021_final.pdf

[12] https://www.businessinsider.com/big-tech-in-healthcare-report?r=US&IR=T

[13] https://builtin.com/healthcare-technology/healthcare-technology-companies

[14] https://www.who.int/health-topics/health-equity#tab=tab_1

Ann Bailey

Senior Principal

Ann Bailey is a Senior Principal on the Implementation Team advising clients across industries on overcoming their communications, strategy execution, and decision-making challenges.

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Nicole Dillner is a Principal on the Implementation team. Leveraging her background in Industrial/Organizational Psychology, she is focused on helping clients improve their team and organizational effectiveness through strategy alignment and leadership development.

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