1. Stewart, Jean RN MSN CNS CNRN

Article Content

FUTURESCAN 2009: Healthcare Trends and Implications 2009-2014

D. Seymour (Editor), Chicago, IL: Society for Healthcare Strategy and Market Development of the American Hospital Association, 2009, 41 pages, $45.00, ISBN 978-0-9800290-3-1.


FUTURESCAN 2009: Healthcare Trends and Implications 2009-2014 is an annual publication of The Society for Healthcare Strategy and Market Development. The society identifies significant megatrends that will impact healthcare organizations and their strategic planning and delivery of healthcare. Recognized experts analyze trends focusing on rationale, interventions, and implications for healthcare providers.


The introduction identifies eight future megatrends that will influence the direction of healthcare over the next 5 years. These trends included globalization, longevity, immigration, new competitors, physician reengagement, health care policy reform, quality-patient safety, and mandatory public reporting. Individual chapters provide a detailed examination of each trend and implications.


Chapter 1 discusses the globalization of healthcare. Foreigners have frequently come to the United States for medical care. Now, Americans are increasingly engaging in medical tourism for more affordable care in foreign countries. Globalization of healthcare providers is also a factor. Currently, American medical and nursing schools are unable to provide the volume of graduates needed. Utilization of foreign medical graduates is helping fulfill our workforce requirements while robbing developing countries of needed medical personnel.


Chapter 2 examines how modern medical care has increased longevity. Little effort has been made to prevent chronic illness or promote healthy lifestyles. Longevity and chronic illnesses will utilize ever-increasing amounts of the healthcare dollar. We may be living longer, but we will suffer with the effects of chronic illness.


Chapter 3 focuses on the increasing cultural diversity of the population. The constant influx of many different cultures will require changes in providing healthcare. Providers need to determine which cultures are in their service area and what their needs are. Providers need to develop cross-cultural communication skills and maintain culturally competent care.


In Chapter 4, new competitors unlike any of the present ones will bring changes to the healthcare industry. Hospitals in joint ventures with physicians, entrepreneurs, and niche players running freestanding convenient care clinics, along with employer-based clinics, will be competing for the healthcare dollar. Healthcare providers need to develop innovative strategies to rapidly deal with new opportunities.


Discussions of physician retention and disengagement occur in chapter 5. Reasons for these issues include technological advances, patient treatment plan control, shifting physician priorities, increasing government regulations, paperwork, malpractice risks, and lack of autonomy, resulting in physician retention problems and decreasing availability to work with healthcare administrators.


Chapter 6 presents discussions of needed private and government healthcare reform. Rapidly rising healthcare costs leads to employers looking for ways to decrease cost, improve quality-safety, and get predictable outcomes for their healthcare dollars.


Chapter 7 delves into quality and patient safety issues. Healthcare organizations are being compared against each other, utilizing more consistent standards. Changes are being developed and incorporated to increase transparency in healthcare.


Finally, in the last chapter, the need for mandatory reporting of quality and safety issues is presented. There is an increase in voluntary disclosure of information by hospitals. Nonreimbursement for preventable complications and errors is traversing from Medicare to private insurance.


The publication provides an excellent overview of the dynamics in present-day healthcare. It looks into the future trends and provides recommendations for healthcare organizations. Recommendations are directed toward healthcare senior management. Neuroscience nurses managing departments, units, and clinicians at the bedside need to have a firm understanding of the complex forces that dictate the direction of healthcare. Knowing what is or may come will allow neuroscience nurses to position themselves appropriately. This publication is an excellent resource for all nurses faced with impending reformation of a failing healthcare system.


Reviewed by Jean Stewart, RN MSN CNS CNRN, Clinical Nurse Specialist.