The Institute for Alternative Futures (IAF) has been using scenario planning in health care for the past 35 years. Their work is worth your attention. If you can predict the most likely future, you can either take advantage of it or take action to shift it to something more favorable.

For that reason I was pleased to participate in a scenario planning experience with IAF last fall in an effort to predict the future of primary care. After extensive interviews with scores of big thinkers in and around health care, IAF identified the following four competing scenarios for the future of primary care:

Scenario 1: Many Needs, Many Models
Scenario 2: Lost Decade, Lost Health
Scenario 3: Primary Care That Works for All
Scenario 4: “I Am My Own Medical Home”

IAF then called in 25 national “experts” on primary care for a 2-day workshop to analyze the scenarios and vote on the one we felt most likely to be dominant for the year 2025. I can tell you that while the “Lost Decade, Lost Health” scenario did not win the vote, it was a very close second. The rest of the workshop was focused on creating 16 recommendations that could steer the future of primary care in a more positive direction.

The scenarios and the recommendations from the workshop are found in the report Primary Care 2025: A Scenario Exploration. The information it contains will heighten your insights and trigger new thoughts and strategies.

The report doesn’t foretell which of the four future primary care scenarios will prove most accurate, but it does provide recommendations we can collectively embrace to improve the eventual outcomes.

There are two recommendations I’d like to draw your particular attention to.

1. The “Enhance self-management” recommendation will be important in every scenario (page 22). The “no decision about me without me” theme brings a strong focus on improved decision quality, self-management, and value-based health benefit designs. The key is to help patients do more for themselves, ask for the care they need, and say “no” to care that isn’t right for them.
2. The “Provide portable personal health records and related health education and choice services for all” recommendation is in the Health Information Technology section (page 23). We would add to this a need to record the patient’s preferences inside the EMR.

While the future is unknown, it is not unchangeable. Primary care will be at the center of health care—and at the center of primary care will be the patient. Healthwise stands ready to work with you to help people make better health decisions.

Read the full report, including a description of each scenario and the resulting recommendations.

PS: I voted for #1 as most likely but hope that a large dose of #4 gets included. Where do you see health care headed?