The healthcare sector is in flux: Regulations are changing, reform may be on its way and the industry is making the shift from volume to value-based care. But while there’s still a lot that Congress and healthcare leaders often don’t agree upon, change is necessary and forthcoming.

“Obviously, there’s a problem, and it’s a big one,” said 4D Healthware Founder Star Cunningham. “It’s a $3 trillion problem. Something has to be done.”

To Cunningham, who served in a number of roles at IBM including as a a managing consultant for its global telecommunications center of excellence and Big Blue’s smarter planet solutions manager, the shift to value is a good one. 

[Also: Institute for Healthcare Improvement's Tejal Gandhi on building a culture of patient safety in hospitals and at home]

For example, organizations will now have to start paying when a patient is readmitted to a hospital, which will pose a serious question: how do I know, as a physician, who’s at fault when a patient is readmitted?

As a result, organizations will begin to look for solutions that provide better care for patients when they’re away from the health system.

Other industries have been engaged with consumers for eons, explained Cunningham. But this is a huge shift for healthcare to be patient-centered, patient-focused and to engage patients.

“In the coming years, with value-based reimbursement, with consumers being more informed I believe we’ll see a strong consumer adoption for health-related products that consumers pay for out of their pocket to give them something to improve their health,” said Cunningham.

Once Apple started charging $1,000 for its iPhone and the market for FitBits and for other health devices boomed, Cunningham explained that it points to all of these pieces coming together.

“[Patients] are going to be willing to pay for something to improve their health and lifestyle,” she said.

The healthcare sector need look no further than the banking industry to see the signs of what’s to come. To Cunningham, the two industries share many parallels.

There was a time when people had to physically take their checks to the bank and hand it to the teller to make a deposit. To get cash, consumers had to go the bank. Now, everything is run by PayPal, eBay, Square and other technologies -- all of which are consumer-driven, explained Cunningham.

“All of these more consumer-focused organizations had to come together to get the dinosaur to move and shift,” said Cunningham. “And the dinosaur has plenty of money, plenty of access, they just have to learn to move and shift.”

Healthcare also shares some of the same challenges and fear-mongering that faced the financial sector. Cunningham explained that some created fears and rumors that people wouldn’t want their financial information so easily accessible, the fear of buying things online, or how people wouldn’t trust machines to take their money.

“I think the challenges come from within healthcare itself, just like those challenges came from the financial industry,” said Cunningham. “You’re going to see those same challenges in healthcare. But you’re going to see consumers demanding more.”

“The challenges are going to come with the gap between consumer demand and the Nordstrom’s of healthcare,” she continued. “And the leader will be the organization that’s willing to provide a level of holistic service to the patient.”

What if a patient could pick between concierge services and traditional services. The concierge services would provide everything to a patient and include emergency services for a set cost of, say, $5,000.

Would a consumer prefer that type of service, or insurance that costs about $500 a month that may or may not cover the needed services?

“We’re now realizing that people are less expensive to keep healthy than it is to treat them once they’re sick,” she added. “Everyone has figured at least that part out. But the conversations need to continue. And we need not allow government, insurance companies and health systems make all of those decisions for them, when it comes to your health.”

Twitter: @JessieFDavis
Email the writer: jessica.davis@himssmedia.com