Malcolm Gladwell opened his healthcare talk with a joke. Confessing that he is expert in neither healthcare nor interoperability, the long-time journalist revealed that he had actually pondered how his former self would cover his present self as a speaker — likely with “quotes out of context and something really snarky.”

The best-selling author and New Yorker staffer likened the change required for healthcare to make it over the interoperability hurdle to several events of this generation, “three lessons in culture, framing and consequence,” as he put it during Health Care Innovation Day.

The first is the Bekaa Valley Turkey Shoot, an incident in the Lebanon War of I982, when the Israelis shot down all the Syrian aircraft within two days while only losing one helicopter themselves, and not to enemy fire.

Gladwell attributes the Israeli victory to interoperable warfare technology. The Israelis, having faced earlier grave losses, were now in a position to make sure their air superiority did not fail them, because in all other ways they were outmanned. They coordinated real-time use of drones, precision guided missiles and airborne warning and control system aircraft to achieve victory on a surprised Syrian air force.

[See also: MGMA keynote warns against healthcare overconfidence.]

The interesting thing to note, Gladwell pointed out, is that the Israelis did not invent the technology. The U.S. and the Soviets did. But the Israelis put them all together to be interoperable, thereby rendering it more effective many times over, and done through the power of an urgency similar to what America now faces with healthcare. 

Gladwell told the next story to show the importance of framing a problem correctly. In the 1950s, America was spending more than five dollars on every ton of cargo shipped, placing a huge drain on the economy. The price of shipping was a result of a shipping trade locked in antiquity.

Docks were a real choke point, until Malcolm McLean (originally in the trucking industry) made some changes that brought the price down to 15 cents per ton, basically revolutionizing American shipping and changing the world economy. The lesson to be learned here, Gladwell said, was how McLean viewed the problem. It wasn’t a trucking problem, a shipping problem or a labor problem. It was a moving cargo problem. McLean came up with a shipping container that could be more easily loaded onto and off of ships, then proceeded to change the culture that went along with solving the problem.

[See also: Lack of interoperability stalls progress.]

To join his war story and shipping tale, Gladwell added historical perspective gleaned from the digital music industry revolution. "In 2001, who would have predicted music stores would disappear within five years?" he asked. But they did. At first, the change was lamented, but as time went on and consumers adapted to the new personalized method of purchasing music, they opened up to spending more money. Attendance of live music events tripled from 2000 to 2010. Overall music entertainment spending went up 15 percent within the last 10 years, all launched by the advent of the MP3 and digital, interoperable music.

"Sometimes when we look at innovation, we make the mistake of thinking that innovation is specific to an individual invention or a device," but that’s not it, he said. "The greatest transformation brought about by technology is when you bring the various pieces and have them work together in combination. It’s the synergies that bring about the greatest changes in the world."

Gladwell concluded by leaving audience members with some advice.

"Take all these extraordinary tools we have out there, and have them work together and who knows what extraordinary changes that can bring about?" he said. "You are on to something very crucial here, and I wish you all the best."