There are as many theories about why punk rock came to be as there are punk-rock progenitors, but like all good revolutions, this one was born out of deep discontent with the times. It was propelled by technical accessibility and entrepreneurship: it was simple and easy to pull off by pretty much anyone. In December 1976, the English fanzine Sideburns published a now-famous illustration of three chords, captioned "This is a chord, this is another, this is a third. Now form a band."

Punk was hardcore Zen, a completely different operating philosophy that undermined the integrity of the culture in which it was introduced. It altered what was meant by a 'new industry model', changing those deeply embedded habits of thought which give a system its sense of what is the natural order of things.

Or to frame it in terms of today's lexicon, punk was...innovative...disruptive....transformative. Nothing was sacred. You could lose yourself in a reactionary had-it-up-to-here fury while also fully savoring the rupture, the novelty of the moment as a cathartic split from convention and cliche.

Punk was a completely different wattage.

A Total Change in Context

Frost & Sullivan predicts the 'outcomes-based care' focus will scale and globalize dramatically, with at least 15 percent -- about $1.5 trillion -- of the $9 trillion healthcare economy worldwide tied to value-based models. Presumably, there will be an invisible hand doing the tying; left unsaid is whose invisible mind is guiding the invisible hand. (Maybe it's better to think of “value” itself as new market space to develop, where B2B strategy and sales will lead the way to above-average growth. Check out McKinsey on this here.) 

Critics say today's health system CEOs have proved unwilling or unable to shift their market strategies to meet the demands of consumers accustomed to rapid, high-quality service in other industries. Writing in Modern Healthcare recently ("As Healthcare Changes, Systems Need to Broaden Search to Find Disruptive CEOs"), Harris Meyer describes the pressure on CEOs to adapt to a total change in context for a modern strategy.

Incoming executive leadership, Meyer says, need a new frame of reference for how hospitals, pharmaceutical and medical device companies, and other delivery systems will be "transformed in the coming years into very different-looking organizations whose focus is on [new industry ecosystems] that keep patient populations healthy in the most cost-effective ways."

"With healthcare changing rapidly, hospital CEO positions turning over at a high rate, and baby boomer senior executives eyeing retirement, some hospitals and health systems realize their next leaders will need a different set of experiences and skills to successfully navigate that new world."

They're in need, it seems, of a Punk Rock vision, a radically different mindset that can navigate the transition and tension between entrenched and emerging modes of being.

The thing missing from the conventional perspective is new understanding: the pieces matter less than the whole, "things" are secondary to experiences. The new business value to extract from healthcare is not from the discrete use of applications or the latest cool tech pilot, but the way these components can meld together to interact and form a broader architecture for managing information.

Quoting CVS Health CEO Larry Merlo:

"[Industry] does not place enough of a focus on outcomes or managing the patient in a holistic way, and all of that leads to -- pick the adjective you want to use -- wasteful, avoidable, preventable spending that amounts to billions of dollars."

Read more of the January 1, 2019 interview with Merlo in the Richmond Times-Dispatch here: CVS got Aetna. Next up, reimagining health care

There are multiple billion-dollar business models and markets to develop based on improving outcomes and squeezing inefficiency from healthcare. (This week, Alphabet's Verily got $1 billion in a new funding round led by Silver Lake to execute its strategic focus on helping healthcare navigate the shift towards evidence generation and value-based reimbursement models.) The path to get there is to make technology so immersive that it disappears into the experience.

New Systems of Engagement

The next healthcare solves for outcomes through market integration.

Winners have the better vision of serving (and sustaining) 'continuous health engagement' over time. And if you buy into the logic that it's not just one thing that improves outcomes, but many things simultaneously and interactively, then advantage goes to those who are best at inventing and managing new industry ecosystems, at scale.

Fragmentation is a design problem: there are islands of features everywhere from too many vendors wandering on the edges, pushing point solutions to small problems. The challenge is pulling it all together in a way that a whole system is born and becomes focused on generative value. The new data that flows from this new system, and then refined into specialized cognition, is the thing that generates new business value, supports population health and guarantees performance.

Data on purpose. You design for the analytics you want to capture.

Or to put it another way, the transformational remit for today's health market leaders is the ability to creatively explore and conceptualize a new territory, quickly assemble the intellectual viewpoint, and then design the new industry infrastructure -- the nervous system -- to own the space. Which is the role of “digital” in this story. It's value is expressed in the ability to dissolve boundaries, create new identities, remove friction and re-configure entire business systems, practically overnight.

Anger is an Energy

From the publisher's note to Anger is an Energy, John Lydon's autobiography:

"This autobiography is by John Lydon in his own words. Sometimes, the organization of those words does not conform to the traditional rules of grammar. In some cases, the reader will happen upon words not listed in the dictionary, or used in ways one might describe as "unorthodox." The publisher is aware of this -- they are not typos or misspellings we have missed; they are part of Mr. Lydon's unique "lingo" and, as such, have been given (mostly) free rein. As John might say, "Don't let riffles cause fraction."

We are now in the 50th year of the official US healthcare "crisis." For more than half a century, ballooning health care costs have been a source of concern, confusion, complexity and impending catastrophe to the American economy and employer operating margins when, on July 10, 1969, President Richard Nixon proclaimed, "We face a massive crisis in this area." Without prompt administrative and legislative action, he added at a special press briefing, "we will have a breakdown in our medical care system."

A Punk Rock vision breaks from the herd of independent minds passing as disruptive. It's about a shift in how to think, not in what to think. It's about using new words to think new thoughts.

Says Michael E. Porter, Harvard Business School and Co-Founder of the International Consortium of Health Outcomes Measurement (ICHOM) in teeing up #ICHOM2019 on May 2-3, 2019 in Rotterdam: "We are starting a transformation of what healthcare is, how we think about it, how we deliver it, how we measure it and the results we are actually achieving."

/ jgs

Originally published as “Healthcare Needs a Punk Rock Vision” on LinkedIn, January 3, 2019

Image: The Sex Pistols perform live onstage at Baton Rouge's Kingfisher Club, Louisiana, on their final tour on January 09 1978 L-R Johnny Rotten (John Lydon) Steve Jones, Sid Vicious (Photo by Richard E. Aaron/Redferns)