Hospital and health system leaders are no longer treating disruption as episodic; it is the operating environment — layered, overlapping, and largely outside any single system’s control.
During an April 13 executive roundtable hosted by Vituity at Becker’s Hospital Review 16th Annual Meeting, executives from more than 20 hospitals and health systems shared how their organizations are adapting. Imamu Tomlinson, MD, MBA, CEO of Vituity, framed the session’s intent: move past cataloging what’s wrong and discuss how health systems, physicians, and partners can “disrupt the disruption” together.
Four takeaways:
Note: Quotes have been edited for length and clarity. Attendee remarks are attributed by role and organization per the roundtable format.
1. Capacity and boarding are where the disruption lands first
Emergency department boarding was the pressure point executives returned to most. A community hospital leader described patients sitting 12-plus hours because transfers to specialty services at sister and partner hospitals weren’t possible — those facilities were also full. A six-hospital system executive described cutting ED boarding by roughly 30% over three months through a daily 15-minute capacity huddle and an internal trade system that redistributed patients across smaller and larger hospitals.
2. ‘We can’t be best at everything’ is moving from talking point to strategy
Multiple systems are actively consolidating or ending service lines. A leader from a large, nonprofit academic health system on the East Coast described ending a thrombectomy program when competing programs matured nearby, freeing space to scale cardiac catheterization to five days a week based on actual community utilization. Another six-hospital system consolidated cardiac and partnered with a local academic medical center on complex GI and liver care.
3. The CFO is in the clinical room — and the ED is reporting to the CNO
An associate CFO with a large, nonprofit health system said finance leaders now sit in interventional radiology capacity discussions, urology recruitment conversations, and daily clinical rounds — not only quarter-end budget meetings. A CEO at an integrated health system in the South said her organization moved emergency department oversight from the chief operating officer to the chief nursing officer and watched staffing barriers fall away; another health system reported doing the same systemwide. The common thread: put accountability in the same hands as the decisions, and close the distance between finance, operations, and clinical leadership.
4. The disruption wishlist: people and alignment, not more technology
Asked what they would disrupt with unlimited resources, executives named people and structural alignment — not technology. A leader from an integrated health system based on the West Coast argued for front-line leader development, citing authenticity as becoming even more important amid the rise of AI.
Dr. Tomlinson argued for radical transparency across systems, physicians, payers, and pharma. A COO from a four-hospital health system in the Midwest called for pushing workforce development further upstream, starting at the high school level. A technology leader at the table said the disruption most needed is alignment — between leadership vision and front-line reality, between workflow and technology, between incentives and outcomes.
Disrupting the disruption
Across the room, the pattern held: systems making the most progress are those willing to stop doing what they used to, redraw who is accountable for what, and bring clinicians, finance leaders, and partners into the same conversations earlier than they used to.
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