This is the second of a two-part guest article contributed by Pediatric Rheumatologist and healthcare thought leader Paul Rosen, MD, a regular contributor to our blog. Dr. Rosen looks at some of the key drivers in healthcare transformation, which might be seen as a field of landmines or opportunities. Part one is titled: The Disruption of Healthcare Has Already Begun.


In so many ways, it seems that the future of medicine is already here. Continuing the list of some of the key drivers in the transformation of healthcare:

The revolution of primary care: The current state of primary care delivery does not seem to be working for patients or for providers. Rushed visits in the office, long waits and frequent outside referrals creates an unsatisfying experience for everyone involved. Watch for giant pharmacy (CVS Health, Walgreens) and retailers (Walmart) to offer more primary care services at lower cost with better convenience compared to standard doctors’ office visits.

Wellness and the measured-self: Sports companies that gather data to enhance performance for athletes are in good position to leverage their knowledge and experience to engage with consumers who are looking for more in the measured-self space. Individual monitoring of not only steps, nutrition and sleep, but also heart rate, energy levels, and other biometrics will continue to trend. Wearable technology and sensors to measure and manage both disease and wellness will continue to emerge.

Vertically integrated services for health systems: Health systems will continue to focus on high quality subspecialty care. These will need to be grouped based on vertical integration where a patient is treated by highly trained specialty teams with care coordination and predictive models for complex conditions. Examples include a stroke team, a cancer team, and a trauma team. Face-to-face based models of care should diminish in the health systems as telehealth and mhealth alternatives take hold.

Consumer engagement: Consumers will become even more engaged with their health care choices as (a) technology and the Internet increasingly educate and enable, and (b) as cost increasingly shifts to their paychecks and out-of-pocket requirements. Consumers will spend more time searching for reliable data on cost, quality and patient experience before making their purchasing decision.

More care decisions will be made by the millennial generation for themselves, their children and their parents. Most of these decisions will be made by women. They will use a mobile device to research services and to purchase these services. What’s more they will avoid telephone interaction with bureaucracies, phone trees and call centers.

How do you see things? Tell us your experience and perspective…

Depending on your prism, health care currently looks like a field of landmines or a field of opportunities.

If you are steeped in the traditional health care delivery models—fee-for-service, face-to-face encounters, volume based delivery, dependence on the large insurers for payment without diversification of your business model—then the current era in health care feels turbulent.

If you are embracing the changes that are already taking place—collection of big data sets, analytics of health care delivery, transparency of outcomes in quality and service, using mathematical models to predict population health, providing consumer-driven health from the mobile device, the blurring of sports performance, wellness and health—then right now is the best time to be involved with health care.

We’d be pleased to hear what you think about the present and pending disruption of healthcare. Is change leading to innovation, improved service and a better delivery system? What’s your experience, and how do you see the future?

Paul Rosen, MD

Be sure to read the first part of this article, presented here: The Disruption of Healthcare Has Already Begun.

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Paul Rosen

Paul Rosen

Pediatric Rheumatologist Paul Rosen, MD, is Clinical Director of Service and Operational Excellence at Nemours. He received a Masters of Public Health degree from Harvard University and a Masters of Medical Management degree from Carnegie Mellon University. Dr. Rosen’s interests include patient-physician communication, family-centered care, and the patient experience. He teaches medical students about improving the patient experience, and he serves as the faculty mentor for the physician executive leadership program for medical students at Sidney Kimmel Medical College at Thomas Jefferson University. Twitter @PaulRsn1


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