• Andrew K Simpson, Alexander M Crawford, Brendan M Striano, James D Kang, and Andrew J Schoenfeld.
• Department of Orthopaedic Surgery, Brigham and Women's Hospital.
• Spine. 2023 Jan 1; 48 (1): 737873-78.

Study DesignNarrative review.ObjectiveThe aim was to utilize the lessons from the digital transformation of industries beyond healthcare, weigh the changing forces within the healthcare ecosystem, and provide a framework for the likely state of spine care delivery in the future.Summary Of Background DataAdvances in technology have transformed the way in which we as consumers interact with most products and services, driven by devices, platforms, and a dramatic increase in the availability of digital data. Spine care delivery, and much of healthcare in general, has lagged far behind, hamstrung by regulatory limitations, narrow data networks, limited digital platforms, and cultural attachment to legacy care delivery models.MethodsThe authors present a narrative review of the current state of the spine field in this dynamic and evolving environment.ResultsThe past several decades of spine innovation have largely been driven by "hardware" improvements, such as instrumentation, devices, and enabling technologies to facilitate procedures. These changes, while numerous, have largely resulted in modest incremental improvements in clinical outcomes. The next phase of growth in spine care, however, is likely to be more reflective of the broader innovation ecosystem that has already transformed most other industries, characterized by improvements in "software," including: (1) leveraging data analytics with growing electronic health records databases to optimize interactions between patients and providers, (2) expanding digital and telemedicine platforms to create integrated hybrid service lines, (3) data modeling for patient and provider decision aids, (4) deploying provider and service line performance metrics to improve quality, and (5) movement toward more free market dynamics as patients increasingly move beyond legacy limited health system networks.ConclusionSpine care stakeholders should familiarize themselves with the concepts discussed in this review, as they create value for patients and are also likely to dramatically shift the spine care delivery landscape.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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