Working as an executive coach and strategy consultant within the healthcare marketplace provides a unique perspective. Over the past couple of years I’ve found myself engaged in projects with global, multi-billion dollar medical device corporations, leading teaching hospitals, information technology leaders, investor-driven start-ups, and regional hospital systems. It has delivered an interesting vantage point to witness the foreshadowing healthcare reform has donned across the landscape. While many of the changes are still yet to come, the impetus of change is already rippling through the sector.

Having the opportunity to see things unfold from both sides of the medical device/hospital, producer/consumer relationship does not go unappreciated. It is a privileged overlook that reveals not only the drivers behind a rapidly changing marketplace, but the initiatives both sides of this symbiotic relationship are scrambling to implement.

Two major shifts are occurring, one leading inevitably to the other. First, hospitals are moving towards evidence-based care. I know this may sound a bit odd and disconcerting to the lay person (i.e. patient) who looks towards medicine and the practice of it as science. Is not science always evidence-based? Well yes, of course it is, in the laboratory or clinical trial. But clinical medicine is delivered through a practice. While we all trust that surgeons and physicians are guided and steeped in the science of medicine, we must also appreciate that once they’re in practice medicine continues to evolve scientifically and technologically.

Medical science does not stand still. The nearly $30 billion in annual, research tax dollars invested by the National Institutes of Health is pushing the envelope forward at an ever-accelerating pace. And this figure doesn’t include the private research and development dollars of biopharmaceutical and medical device companies. In fact, it has recently been projected that humankind’s scientific knowledge is doubling every five years. How many peer-reviewed, clinical studies can we expect even the finest surgeons and medical practitioners to read every year?

Surgeons and physicians do the best they can to keep pace with the state of the science, but traditionally, they practice medicine within a relatively small community of peers, institutions, and colleagues. The practice of clinical medicine, unlike many other technologically-driven industries, has been fragmented. All of the critical-to-quality variables that have been captured, analyzed, and applied in aeronautics, electronics, software, automotive engineering, pharmaceutical manufacturing, even the frying of the perfect fast-food french fry have been unattainable in clinical medicine. Until now.

The federal requirements for automating patient records is unleashing a new age in medicine. And patient records are just the beginning. The application of informatics, the ability to capture large, statistically significant pools of clinical data regarding demographics, genetics, presenting conditions, treatments, surgical procedures, peri-operative care, and patient outcomes is driving a seismic shift in how medicine will be practiced in the future. It is probably the last frontier, the last industry to benefit from transposing raw data into cogent information that will dramatically effect quality, costs, and the standardization of processes to optimize both of these factors simultaneously.

The net effect of this is a fundamental shift in the buying influences and decision makers for purchasing medical devices within the hospital. Once the sole domain of surgeon preference, these decisions are now migrating to value-add committees; teams of clinical and administrative professionals that are looking to optimize the coming wave of efficiencies and positive patient outcomes that are the promise of evidence-based care. Which brings us to the inevitable and immediate challenge of medical device manufacturers. The entire criteria for who, where, and what will be purchased is spiraling away from their traditional sales and marketing model.

The sales engines of multi-billion dollar medical device companies are not haphazard organizations that organically sprouted up in the marketplace. These are organizations that have been meticulously optimized by a continuous succession of exceptionally bright professionals over a hundred years of market presence, and, in many cases, decades of distinguished market leadership. These are organizations of pride and pedigree. Organizations that fine-tuned the wining and dining of key decision makers, of hiring and the training just the right type of sales professionals capable of persuading key surgeons, clinical opinion leaders, and early adopters of sway within the clinical community. Vastly expensive enterprises of dozens, if not hundreds, of highly paid sales mercenaries that invested years, if not decades, in cultivating key relationships and a professional presence within their territories.

The tidal shift that is occurring in the marketplace is rapidly displacing the traditional value proposition and delivery vehicles of these finely tuned machines. These are not frigates that can turn on a dime. They are the equivalent of aircraft carriers being tasked to come about in the middle of the Suez Canal without losing steam or momentum. Many medical device companies recognize they need to adapt to dramatically different circumstances of which they collectively have no historical experience in navigating. Keep in mind, cataclysmic change rarely serves the incumbent. Well established and longstanding careers emerged and evolved under very different drivers, influences, and environments, solidly anchored to the past. Transformational change does not come easily.

All of this culminates in the need for medical device companies to find new, unprecedented approaches for developing, marketing, and selling their technology. Their is no turnkey, off-the-shelf solution for adaptive change. Adaptive change requires a shift in perspective to occur, for fresh thinking to emerge, and for new, efficacious processes to coalesce. The imperative that will enable adaptive success requires organizations to align and leverage their leadership, strategy, and culture; fully engaging the human talent and intellectual property they enjoy. Adapting to the transformational and rapidly shifting healthcare environment will require the courage to step away from timeworn sales and development models and discover entirely new paths to market.

With what we are witnessing, I cannot help but think of Darwin and his theory of evolution. Many people misunderstand his theory of survival of the fittest. It isn’t the strongest, the largest, or the most intelligent that survive. It is those that are the most adaptable to change. And as it is with species, it will be with today’s medical device companies...those that are most adaptable to change will be those that thrive in the future.