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Everybody’s Talking about the Future of Health Care

by Fred Fortin

I don’t know if you’ve noticed but as we move into 2008 there’s a glut of papers, reports and predictions about what is going to happen in health care. Some have such a definitive tone, it makes you wonder if any have read Nassim Nicholas Taleb’s, The Black Swan, which engenders in the reader a humble appreciation and respect for role of high impact, improbable events in social affairs.

Anyway, I’ve taken the time to look through some of these pronouncements. Many are rehashes of the what I would call “more of the same” prognostications, others find us at various tipping points — unsustainability being a key concept here — in health care and forecast some, often vague, deep changes to come. Below are some of the bits and pieces of these various offerings of the future that caught my eye.

  • Expect large institutions to make significant IT investments; RHIOs will still struggle with architecture and governance models; EMRs creep closer to reality, and health plans will continue to implement consumer-directed vendor partnerships. (Forrester)
  • Doctors are using the Internet far more than their national averages, using email, obtaining professional information from online journals, attending courses and conferences, receiving professional updates and performing professional, administrative functions. . . In essence, in the short space of time that the Internet has been easily accessible through the Web, doctors have harnessed its power in both their personal and professional lives. All indications are that they will continue to do so. ( Masters)
  • Two areas that are going to get a lot of play in the next year or two. There are a number of products in the telemedicine space that use IT not as a database or workflow tool, but as a telecommunication and management system, teleradiology is one prime example. The other is interoperable home-monitoring devices. There’s good value with keeping people out of nursing homes, and it’s getting a lot of attention right now from doctors, hospitals and health plans. (Brailer)
  • Don’t see much of a business case for health 2.0 technologies, although personal health records as a concept has some validity, particularly as a service provided by health plans and employers. Still in a wait-and-see mode on PHRs. (Brailer)
  • Medicare’s Hospital Insurance (HI) Trust Fund is already expected to pay out more in hospital benefits this year than it receives in taxes and other dedicated revenues. The growing annual deficit is projected to exhaust HI reserves in 2019. (Friedman)
  • For the first time, a safe, effective and reversible hormonal male contraceptive appears to be within reach. Several formulations are expected to become commercially available within the near future. Men may soon have the options of a daily pill to be taken orally, a patch or gel to be applied to the skin, an injection given every three months or an implant placed under the skin every 12 months. (Schieszer)
  • U.S. health care costs are growing at 8 percent per year, an unsustainable rate that will be forcing every employer to make a crossroads decision in the next 12 to 36 months: either continue to provide health care benefits to employees and become very aggressive about controlling expenses or exit the insurance market completely and let employees fend for themselves. (Deloite)
  • Physician-hospital tensions will increase. Employer-health plan tensions will increase. The non-conventional provider movement (complementary and alternative medicine) will be pitted against the conventional. Off-shore resources will compete against high-cost domestics. The under-insureds will compete with employers for funding and services. Biologics developers will attempt to fend off traditional pharma to capture the high ground in diagnostics and therapeutics. Tension, anxiety, and turf battles for success will heat up, but so, too, will opportunities. (Deloite)
  • In an environment where employers and consumers are demanding more for less, medical tourism, telemedicine, and other innovative disruptions offer attractive options for people who require expensive surgery and procedures but do not want to be limited by their health care insurance policies. (Deloite)
  • Significant change is unlikely prior to 2010 and is apt to be gradual thereafter. Although urgency is still the operative word, the players involved have a healthy respect for the complexity of the problem and the runaway costs that will result if they get it wrong. Even if some changes emerge in the first year of the new administration, implementation would take at least a year. Bigger changes would probably follow, being phased in starting in 2011. (Booz Allen)
  • A surge in the number of retail clinics will force states, payers, and policy makers to think about the right model for the delivery of primary care. (PWC)
  • The market for individual health insurance could take off. (PWC)
  • We envision the proliferation of “health infomediaries” (HIs) who help consumers navigate the insurance, channel and service options in care delivery. HIs will become a fixture in the landscape for both the well and the chronically ill, and for a much broader socioeconomic segment of the population. (IBM)
  • The combination of the push for universal coverage, the erosion of employer-based insurance and the aging population is expected to drive this continued shift to individual and government-based coverage. (IBM)


[…] my full post over at the World Health Care Blog. Posted in Healthcare. Tags: future, […]

  Mike Pringle wrote @ January 18th, 2008 at 2:36 pm

Thanks for the chance to comment again Fred. Being a new blogger with my own site I try and see what others are doing, keep up the news as best I can and throw my two cents in since I have been working in healthcare for some twenty years now. I don’t profess to be the Rosetta stone in healthcare by any means, and I usually get change from my two cents.

I see a lot of predictions as you mentioned, almost a Nostradamus of healthcare pandemic has touched off the new year. I suspect a lot more attention due to the elections. Everyone has their own thoughts on how the pendulum will fall.

Healthcare is a huge beast with many interconnected variables. You can’t change one part of it without it effecting all the others in some way. I think healthcare will stay exactly how it is in 2008. Coast will stay high, large numbers of people will still not have insurance coverage, emergency departments will still be over crowded, and insurance companies will continue to tighten the reimbursement ropes. Perhaps some financially strapped hospitals will go under or new health systems will emerge to try and pool recourses.

It is entertaining to see people at their crystal balls though :).

  Health World Web » Blog Archive » The future of health care wrote @ January 19th, 2008 at 11:29 am

[…] Fred Fortin looks at various prognostications and offers a few of his own, including his skepticism about Health 2.0. Don’t see much of a business case for health 2.0 technologies, although personal health records as a concept has some validity, particularly as a service provided by health plans and employers. […]

  Scott Smith wrote @ January 21st, 2008 at 2:44 pm

Jan. 21, 2008

As a fellow Journalist and Director of Public Relations for MyMedicalRecords.com (“MMR”), I read with great interest your blog of Jan. 18, which mentioned electronic medical records and thought you would find MMR of interest. MMR has contracts with organizations covering more than 30 million lives to provide our services.

Contrasting MMR to other popular EMR products, MMR is delivering the most user-friendly, convenient and versatile web-based Personal Health Record available today. Using our proprietary patent pending technologies, complete patient information including actual lab test results, radiology reports and images, progress notes and all of a patient’s charts can be uploaded or faxed with annotated voice notes and comments directly into the user’s password-secured account. Users do not need to install any special software or use any special hardware to use our service.

MMR also has integrated other advanced features, such as multilingual translation, a drug interaction database of more than 20,000 medications, calendaring for prescription refills and doctor appointments, and private voicemail for a doctor’s message and other personal uses.

There also is a special “Emergency Log-In” feature that allows a doctor to access a user’s account to view their most important medical information in the event of a medical emergency. To ensure individual privacy, specific data, such as prescriptions, allergies, blood type and copies of actual medical files or images, are pre-selected by the user for inclusion in the online read-only Emergency Folder.

In addition, MMR also includes an online ESafeDeposit Box feature that enables users to securely store any important document in a virtual “lock box” and access them anytime from anywhere using an Internet-connected computer or PDA. These documents can include Advanced Directives, Wills, insurance policies, birth certificates, photos of Family, Pets and Property, and more. MMR is clearly one of the most complete user-friendly Personal Health Records available today.

I would encourage you to visit MMR and set up a complimentary account. Simply go to www.mymedicalrecords.com and sign up using registration code MMRMEDIA. I would be interested in your experience and hope that you will include us in any further discussions of Personal Health Records. I could also send you more information by email or snail mail (the latter allows a more complete kit, since I wouldn’t want to send more than a couple of comparative items by email).


Scott S. Smith
Director of Public Relations
11000 Santa Monica Blvd. #430
Los Angeles CA 90067
Ext 123 (Cell: 310/254-4051)

[…] Everybody’s Talking about the Future of Health Care (World Health Care Blog) […]

  卫生保健发展的预测 | 鴉打歎茶之地 wrote @ January 24th, 2008 at 4:58 pm

[…] Fortin收录了一批对卫生保健预测的言论,我认为以下部分和内地卫生保健发展的现状与趋势有关: Doctors are […]

[…] my last post, I ran through a number of predictions about the future of U.S. health care distilled from the […]

  Predictions…Not Mine « Patient Centric Healthcare wrote @ January 25th, 2008 at 11:12 pm

[…] right now (still digging out from vacation)…I will simply point you to a good summary on the WorldHealthCareBlog about what people are predicting for 2008 and beyond around […]

  Scott Diering wrote @ February 5th, 2008 at 6:04 pm

This is a very thoughtful piece. However, I think we should focus on the forest, not just the trees. As you mention in your seventh point, healthcare costs are out of control. And our free market will soon control them for us. This will happen in a very accelerated rate if there is an economic downturn, and employers need to cut costs quickly.
How can we stop our raging healthcare costs? We’ll need a complete shift in our society’s viewpoints: From expectation of perfection to the recognition that healthcare is not perfect; From attack and blame to acceptance of personal responsibility; And from self centered to group centered thinking. But this may take a long time.

  Womenhealth :: More Predictions on The Future of Health Care wrote @ February 18th, 2008 at 6:08 pm

[…] post, “Everybody’s Talking about the Future of Health Care,” by Fred Fortin over at the World Health Care Blog. The post focusing our attention on what may […]

  State Fair » Ranch Events wrote @ March 19th, 2008 at 6:25 am

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