Resistance is Futile

By Charlie Miraglia

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For all of the Star Trek Next Generation and Voyager fans out there, saying “Resistance is Futile” requires no explanation. For the uninitiated, these words are commonly uttered by a hostile alien race, the Borg, who were committed to “assimilating” the biological and technological distinctiveness of every race they encountered throughout the galaxy and adding these features to their makeup. They refer to themselves, appropriately, as “the collective”. And although I’m not usually in the habit of agreeing with the bad guys from pop culture, in this case a little assimilation may be just what healthcare needs.


For far too long doctors, nurses, and healthcare executives have been resistant to change and content to live in a world of real, figurative, and self-imposed silos of care – silos for each specialty or each clinic or each hospital and so on. Technology is scattered throughout the suites of outpatient facilities and the diagnostics departments of hospitals everywhere, collecting dust and wasting money. Fancy machines and their “specialized” systems of record, capable of amazing feats like 3D imaging and laser-focused, robot-driven diagnosis and treatment of a whole host of diseases, litter the floors of every respectable healthcare institution in this great country of ours. Sadly, the sharing of patient information and the personalization of healthcare still seems light years away for many of those brave souls on the front lines of the industry.

What’s keeping healthcare from embracing new technologies that will drive patient engagement, ensure accountability and improve the experience overall? One opinion is that it’s the false sense of safety and security that healthcare executives, and unfortunately the majority of physicians, feel for the status quo. Their skepticism, or even complacency, is not surprising, since they have almost certainly lived through multiple initiatives in their careers that didn’t yield the expected results and were eventually abandoned. Let’s face it, everyone in healthcare understands what it’s like to have multiple projects going on at the same time, and with too few resources to get things done adding another one never sounds very appealing.


The good news is that a perfect storm of sorts, or an alignment of the stars if you’d prefer, has been created recently in healthcare. The Affordable Care Act (ACA), for starters, has led to the challenge of covering the health and wellness of millions of people previously without insurance. In addition, the creation of ACOs, patient-centered medical homes, and other care delivery models has led to a re-examination of how best to care for people both in and out of the hospital. Add to that the shift away from a fee for service based system towards a pay-for-performance one, and we’re on our way to some major changes in how healthcare works.

Obviously, how we as a society pay for that care with limited and diminishing resources is also under scrutiny. It’s this realignment of incentives, shifting toward value and away from volume, which should inspire the adoption of new technologies across provider organizations and lead us into the next generation of healthcare delivery systems. Healthcare needs to break free from the significant gravitational forces of the past and follow the early adopters and visionaries embarking on the voyage into the future. It’s no longer a question of “if” change is necessary; the greater risk is in making the decision not to change, or changing too slowly and getting left behind. The time has come to lead healthcare forward, to boldly go where no one has gone before!

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