Healthcare Disrupters

June 2020 Vol 13, No 3 - Editorial
David B. Nash, MD, MBA
Editor-in-Chief, American Health & Drug Benefits; Founding Dean Emeritus, Jefferson College of Population Health, Philadelphia, PA
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Certain words are solidly embedded in our current healthcare lexicon, including “innovation” and “disruption.” I am confident that our readers have heard these words in everyday conversation with colleagues across all healthcare stakeholders, especially administrative leaders. I am always on the lookout for new reports that may provide insight into innovators and disrupters.

For that purpose, I’d like to share with our readers a recent report from Deloitte Center for Health Solutions, titled “Six Assumptions for Measuring Health Disruption: The Future of Health Is Further Along than Some Might Think,” by Neal Batra and Maulesh Shukla.1

These experienced national consultants believe that we are well on our way to a totally different healthcare system, suggesting that by 2040—just 2 decades from now—we will pass through 3 distinct periods. Each of these 3 periods encompasses close to 7 years, which they call “initiation,” “proliferation,” and “transformation.”1

In each of these 3 stages, Batra and Shukla outlined 6 broad assumptions that, in their view, create a vision for the future. I will list the 6 broad assumptions and then give an example of the disruptive behavior that is associated with each of these assumptions. According to Batra and Shukla, the 6 assumptions that will be the “jumping-off points in measuring progress” include1:

1. Data-sharing, in which consumers willingly share data that are captured and owned by many entities in the healthcare market
2. Interoperable data, in which large aggregated data sets provide real-time, complete views of consumers and their environment
3. Access to healthcare. The use of a radically transformed healthcare system can significantly reduce traditional barriers to healthcare access, such as geography and a shortage of resources
4. Empowered consumers. Today, consumers are no longer passive participants in their care; instead, they are demanding transparency, convenience, and access to drive the transformation of healthcare
5. Behavior change. When patients do not feel empowered or feel they are unable to be responsible for their health, they cannot modify their behavior to affect their disease in a positive way. New technology that is tailored to consumers’ interests will enable people to change their behavior and take better control of their well-being
6. Scientific breakthroughs. Advances in healthcare, such as use of stem cells, nanobots, and biome sensors, will take place at an exponential rate, which will build on the insights obtained from radically interoperable data.

Wow! These 6 broad assumptions are exciting in and of themselves, and kudos to the Deloitte team who has thoughtfully outlined these areas of “disruption” that will characterize the next 2 decades.

Allow me to elucidate these 6 assumptions with 3 current examples, and to prognosticate about the road to 2040 as it relates to the third broad assumption, namely, access to healthcare. The example in the report regarding the University of Florida Family Data Center is intriguing. At that university, researchers and community partners have generated geospatial “hot spot” density maps.

According to Batra and Shukla, “These maps show critical data access to healthcare, such as Medicaid births, low birth weight, domestic violence incidents, child maltreatment reports, and unexcused school absences. The insights gleaned from the density map resulted in the system building a family resource center in the neighborhood of greatest need, as well as a mobile clinic staffed by clinicians and volunteers.”1 To me, this sounds like population health management coming to life regarding access to information across the spectrum of stakeholders involved in delivering care.

The fourth broad assumption, namely, the empowered consumer of the future who appreciates and demands convenience and transparency, is best illustrated in the report by Iora Health. Iora is a digitally enabled primary care and behavioral care provider for its Medicare beneficiaries.

According to Batra and Shukla, “Iora provides all its patients with a care coordination team including a health coach. Patients, especially those with chronic conditions, feel at ease to have frequent ongoing conversations virtually with their health coaches. A majority of these conversations are enabled by their digital platform, with all patient data in a single place.”1 In the past 3 years, Iora has more than doubled its number of members, and has helped to attain a 40% reduction in hospitalizations and 20% less emergency department visits.

The fifth broad assumption—behavior change—is of great interest to our faculty at Jefferson College of Population Health. We agree with Batra and Shukla that “The introduction of AI [artificial intelligence], VR [virtual reality], AR [augmented reality], remote care, and sensors that are tailored to consumer interests and health status can empower patients to take control of their holistic well-being.”1

The authors note that these technologies (ie, AI, VR, and AR) will be present in all homes by the end of the next decade. This will further enable the continuous monitoring and personalization of artificial intelligence that will drive consumer adherence to treatment and overall behavior change that promote well-being.

Personally, having been in primary care practice now for more than 35 years, I hope that I am around to see the implementation of this technology on a widespread basis. It clearly would be a complete disruption to the healthcare system.

In summary, these 6 broad assumptions and the 3 eras over the next 2 decades are a nice framework for a deep dive into the roots of disruption in the healthcare system. Our readers could probably name additional examples of disruption under the remaining assumptions that I did not have space to review.

I hope I will be a healthy participant at age 84 to see some of these 2040 predictions that are outlined by Batra and Shukla. It sounds very exciting now, and by 2040, I may need the technologies described in this forward-­looking report for my own health and well-being!

As always, I am interested in your views about these predictions for 2040. You can reach me via e-mail at This email address is being protected from spambots. You need JavaScript enabled to view it..


  1. Batra N, Shukla M. Six Assumptions for Measuring Health Disruption: The Future of Health Is Further Along Than Some Might Think. Deloitte Insights; 2019.­for-measuring-health-disruption/DI_Six-assumptions-for-measuring-health-­disruption.pdf. Accessed April 2, 2020.
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