An entire city had been burned to the ground.  It would never be the same.  It would be better.

It was 1871.  It was Chicago.  A fire had just destroyed 17,500 buildings and left one out of every three residents homeless.

The compelling story behind the Great Chicago Fire is not that Mrs. O'Leary's cow started the fire by kicking over a lantern – that actually never happened.  The interesting part is not what caused the fire; it is what emerged from it – which can give us a powerful lesson about where we can take healthcare, which in many ways is on fire like never before.

In the aftermath of the fire, ideas poured in on how to create a new and better city.  From those ideas, the Great Chicago Plan was created. Rubble would become landfill to create a lakeshore that never existed before. New fire standards were created that became the standard nationwide. This stream of innovation would lead to a new kind of building, called the "skyscraper,” literally changing urban landscapes, not just in Chicago, but around the world.  

The end result? Over the next 20 years, a city virtually destroyed somehow tripled in population. By 1893, Chicago became an international center of excellence, hosting more than 20 million visitors for a world's fair, the Columbian Exposition.  

2013 is our 1871
The question we need to ask ourselves is if an entire city can be leveled, yet emerge stronger in the span of only 20 years in the 1800s, then how can we leverage the incredible ideas, resources and technology we have access to today to build the type of healthcare system we want to leave behind for future generations?

For those of us who have been in healthcare for many years, we take this question as an obligation and we take it very seriously. In that light, we need to view 2013 as our 1871. The rate of change taking place is breathtaking – the advent of new systems (information technology), new structures (accountable care organizations), new incentives (value-based purchasing), new partners (hospital-employed physicians), new payers (both private and public health insurance reform), new players (retail health), new data (business intelligence, decision support), and the list goes on.

[See also: Mostashari: 'We are committed to IT'.]

In other words, with all of this change coming, it is the ‘perfect storm’.  Or, better said, it is the ‘perfect fire’.

The question is whether we will fight it as an uncontrollable fire or whether we will embrace it, leveraging it as a clearing of the way for something better. While all stakeholders face this question, it is clear that some are taking action and others are already being left behind.

Cost of care…a burning platform
An important example of this is how some are tackling what many believe is the burning platform of our time – the rising cost of care.