Evolution and Healthcare IT

When I was taught the theory of evolution in school, I was under the impression that species evolved slowly, over millions of years, leading steadily toward more advanced life forms more capable of dealing with their environment.  I can still remember the  March of Progress or the “ape to man” illustrations of earlier versions of our species, each appearing to be more like us and standing more upright as you moved left to right through the images.

As an adult, I learned more about how evolution actually worked.  In nature, it never was a straight line from less efficient species to more efficient ones.  The reality was that nature adapted to its environment through trial and error.  For every advancement through genetic mutation, millions of mutations created less efficient organisms that never survived.  In addition, from time to time, mass extinction events wiped out a majority of the species on earth leaving nature to start over, nearly from scratch.  This lead to two different evolutions of dinosaurs and the eventual rise of the mammals.

March of Progress
Matt Groening – Homersapien


Today, many scientists believe that we are living during another mass extinction event.  The last few hundred years represents a single second ticking off the cosmic time clock, yet during this time our planet’s resources, atmosphere and balance of species has changed dramatically.  As we live our lives and go to work each day, most of us fail to recognize these changes, deny that they exist, or fail to take any action to adjust to them. 

Evolution is not just a process of nature, but affects any process where change is introduced.  In healthcare, our environment is changing dramatically with the increase in the average age of our population, the resistance of our society to pay increasing amounts for care, the improving technology for the delivery of healthcare and the increasing ability to analyze these existing processes and create new ones. 

In this type of evolution, change does not occur over millions of years, but over only a few years, and sometimes months.  Like in nature, we will not slowly adapt to this new environment, new models of healthcare delivery and analysis will appear like genetic mutations in nature, taking hold when they are more capable of adapting to the environment and failing quickly when they cannot.  Like in nature, our very survival as businesses is at stake.  Unlike in nature, our ability to adapt is a choice, not a random event. 

With the introduction of ICD10, the development of healthcare exchanges, new analytics capabilities and new payment models, opportunities exist to leap forward with new concepts that can take advantage of these opportunities and place us in positions to benefit from these changes while those not adapting, wither and die.   I believe that this is the mass extinction event for our current healthcare business model.  We will not be able to survive the coming tide of additional services required for our aging population and the associated increased utilization of services with the revenue generated from our existing system.  Something, probably many things, will have to change. 

For many people, this is a negative situation.  Like the dinosaurs, who would prefer munching on tree tops instead of moving north to cooler temperatures, they are content to continue their existing habits even while the environment becomes increasingly uncomfortable.  For others, this is an opportunity.  People must have healthcare and we are capable of providing the best on the planet.  For this to continue, sacrifices will need to be made on all fronts.  Efficiency will need to improve.  Drastically new methods of delivering, measuring and analyzing these processes will appear.  Most will fail, but some will survive. 

For me, this is an exciting time to be in the healthcare IT business.  There are so many opportunities to employ existing technology to this problem that we often reject many potentially beneficial and profitable opportunities to focus on the ones we feel have the best chance of success. I expect we will try and fail, as we have done in the past, but I am confident that some our current and future services will find a place in this new environment and grow and adapt as they are refined to occupy a permanent place in the healthcare landscape.


By Kalon Mitchell, President – MEDTranDirect