In March, Gartner published an interesting, predicting-the-future piece of research entitled, "
U.S. Healthcare 2019: Implications for Care Delivery Organization Strategy and IT Investment Priorities. " Gartner used scenaric-thinking methodology, which is described in the pub. One of the keys to this methodology was to identify critical uncertainties. In it, the analysts concluded that proximity was one of these uncertainties:
Will most healthcare be local going forward?
The second critical uncertainty was whether incentives will change from the current predominance of activity-based services (aka pay-for-procedures), to a more value-based, coordinated care model. The new HCIT requirements for unified communication and collaboration are both exciting and daunting. There's a nice, cross-industry vision for unified communication and collaboration
here (from Microsoft).
Today's prevalent model is where the patient is physically present with the care provider, and activity-based, which Gartner dubs, "Herky-Jerky Care."
The 2009 study of possible 2019 futures is especially interesting, intriguing when you go back and look at Gartner's 2000 predictions of possible 2010 models.
However, to clarify all this for non-Gartner clients, the paper closed with a "Summary and How to Prepare" for future potential scenarios. In 2000 the group's analysts wrote the following sentence:
If the economy fails and there is not money to invest in standards development and the new systems that will be required to implement those standards, we will be in Quadrant C [Irrational, "Brute Force" Rationing] (0.7 probability).
Many providers are experiencing Value-Based, Quality-Oriented purchasing initiatives as "Brute Force Rationing."
Although we don't (currently) have a Single Payer, there has clearly been government leadership (or intervention, if you prefer) in the payment reform we've seen in the recent decades, since commercial payers often follow CMS's lead.
This 2009 Gartner publication is currently
freely available here. Note, the piece was published about a month after ARRA/HITECH, and before the Meaningful Use, Certification, and related healthcare reform dialogues. It makes for good reading and moves the critical uncertainties axes forward in an interesting way from a decade ago, highlighting globalization, both geographic, and the care continuum.
The accuracy and predictive power of Gartner's 2000 predictions about today's scenario really reinforce the value of indepth, cogent and futuristic research.
The question remains. Have we read, do we understand, are we prepared, are we willing, and will we act . . . responsibly? I think that means a substantial focus on care coordination, beyond the four walls of our facilities, no matter which scenario dominates our future. Where do you stand?