If you are a successful operating organization in the healthcare industry today, you are about to be challenged in ways you might not have thought possible until quite recently.

We are often asked by our clients which trend in the healthcare industry today will have the greatest impact on their viability and success. Of course we have to tell them, “It’s complicated”. It is. No single trend by itself will determine your fate.

But whether you are a payer, employer, provider system, physician practice, or a technology/services vendor to one or more of the above, it is imperative to recognize the significant disruptive impact of a phenomenon we call devolution of healthcare services.

Devolution is happening simultaneously across three industry dimensions:

1. Providers

Devolution of healthcare providers is driven by an increasingly severe shortage of physicians and a grudging recognition that many healthcare services can be provided with quality by “physician extenders” of various types.

The result is that clinical patient care is increasingly provided by non-physicians along an education and experience continuum that includes physician assistants, RNs, pharmacists, home health aides, family member caregivers, and even patients themselves.

2. Service Settings

Devolution of healthcare setting means that care is increasingly provided across a spectrum of facilities outside the hospital. Examinations, tests, and procedures that previously were typically performed in the hospital are instead being performed in a wide variety of outpatient settings.

These settings are more appropriate and specialized to the service being provided and include the full range of urgent care centers, ambulatory surgery centers, retail clinics, physician offices, surgical nursing facilities, assisted living and long term care facilities and even patient homes.

3. Technology

And devolution of healthcare technology brings clinical and information technology capabilities closer to the patient wherever they are. Technology supporting diagnosis, monitoring, and clinical procedures that was recently only available in the hospital setting is now getting smaller, cheaper, and simpler to operate.

As a result, it is moving out to the devolved care settings described above. In addition, new sensor driven technology will collect very large volumes of health and clinical data from all settings, including patient located devices and even wearables, in real time. Combined with improvements in mobile and tele-health technologies and information exchange, this will support integrated care management approaches critical to value-based healthcare.

Survival in the New Democratized Landscape

No matter what your organization’s role in the healthcare ecosystem, your ability to survive and thrive in this disruptive environment depends on how you assess and react to the resulting challenges and opportunities for your business model. Your viability and future success will be driven by whether you take optimal advantage of these changes ahead of your competitors.

You can start by looking in more detail at how the payers, employers, providers, and industry suppliers of various types are being challenged by the devolution of healthcare services and consider possible resulting opportunities where innovative approaches can provide an edge.

You can also actively seek approaches to identifying innovative business and operational strategies to evolve your traditional hospital-based business model to the fully integrated healthcare management model of the near future.