Your Health Ecosystem is Growing – and Your Epidermis is Showing

"Ecosystem" is a new favorite buzzword among consulting firms, particularly in industries where new market entrants and digital technologies are expanding the roster of co-dependent participants, becoming more consumer-centric. For me, ecosystem still conjures up 4^th grade science class depiction of an amphibian's ecosystem. An ecosystem (as defined by reliable dictionary.com) is 'a community of organisms together with their physical environment, viewed as a system of interacting and interdependent relationships and including such processes as the flow of energy through trophic levels and the cycling of chemical elements and compounds through living and nonliving components of the system'.

In the context of health industries, "ecosystems" accurately depicts several key aspects of momentum and causal relationships among a growing volume of stakeholders and participants, including:

Widening ripple effects

Health systems are premised on interactions – impacts to cost, access and care quality are not just the patient/clinician and payers/providers, pharma/treatments or governments engaged anymore. The pond now has actors from digital technologies, telcos, retail, automotive, hospitality and, lest we forget, food and wellness industries among others acting and reacting to health economic opportunities. Interactions and interdependencies for positive economic and person-centered health outcomes is reliant on an ever expanding set of players.

Process flows, energy and cycling of compounds throughout the components

In the health ecosystem, the balance is shifting, as more risk is transferred form the HC payers to the HC providers and consumers directly. Typical entry points to health systems are growing – it is no longer just ER's, hospitals and doctors' offices only, more health processes are beginning with web searches, retail clinics, remote monitors/wearables, apps and e-visits from consumer hand-held devices to home-based care and mobile treatment deliveries. Processes are flowing from clinicians to pharmacists, nutritionists, chiropractors, acupuncturists, physical therapists – and care coordination is increasingly complex. Life sciences companies want more direct access to consumers, payers seek to steer patients' navigation to the most cost-effective care options – both seeking to change the flow and origin of consumer energy. Health cycles are growing broader, with involvement from more sources of health advice, new pharma compounds and med device components at play. The flow of funds is coming from consumers – really making our individual choices the origin of energy in the cycle.

Limited resources creates survival risks

Increased sources of demand for health services, from older, sicker, more chronically ill patients globally is draining up care resources. Access to medical talent, health experts, on-call specialists, along with funding for treatment testing and drug development, reimbursements drug testing and employers' share of health costs are diminishing. Narrow networks, high deductible plans, physicians opting out of value-based arrangements potentially limit access to care providers from those who need it most. Risks associated with care quality, access, costs – are compounded by new risks of disintermediation, disruption and digitally enabled alternatives like telehealth, retail and convenient health kiosk locations. These new colored frogs put lots of traditional health business at risk of extinction.

A community shared environment

The extended community of health actors in exponential growth mode – yet, still serves very local, distinct populations making individual context essential. Entities already serving and looking to get into the community are identifying exactly where to solve for needs in the community. Health is a sharing environment, more today than ever with clinically integrated networks, shared risk and payment models, extensive need to share data — and this sharing economy is going more digital, collaborative and convergent daily. Even when no one likes to share rewards, not in profit-driven private health sectors, health outcomes simply are shared for better or worse across the environment, like a rainy season, a blight or plentiful Spring – it just depends on how a player embraces changes – can it go from survive to thrive?

Your health ecosystem is growing, all around you, like dewy moss and prolific bacterial formations. A complex interchange of entities is involved in person-centered health as the flow of funds trickles out to test new waters, prove areas that will thrive, as older elements in the ecosystem either erode or find a way forward (likely through making friends, sharing and partnering even when it's uncomfortable). Are health industries an ecosystem going through transformation by way of disruption, seeking innovation to enable sustainability? You betcha. And more than likely, your epidermis is still showing.