“You cannot create the future using the old strategy tools … The big challenge in creating the

future is not predicting the future; instead, the goal is to try to imagine a future that is plausible,

that you can create.” ~Charles Handy

 

Blip-Zip Summary and Takeaways

Health futuring empowers healthcare organizations to navigate the future with strategic foresight and proactive planning. This article outlines 7 actionable steps, led by a dedicated GROUND 0 Champion, to scan the environment, analyze assumptions, craft scenarios, develop forecasts, and create impactful outbriefs. By embracing this future-oriented approach, organizations can ensure relevance, agility, and higher-quality care for generations to come.

  • Embrace strategic foresight thinking to shape your healthcare organization’s future.
  • Develop a GROUND 0 Champion to guide and inspire health-futuring initiatives.
  • Implement the 7-step framework, from scanning the environment to creating actionable outbriefs.

Introduction to Health Futuring

Proactive adoption of health futuring will lead to innovation, adaptation, and agility throughout the health organization. Moreover, it does not have to be an elaborate process only consultants and large health systems undertake.  For example, many health futurists see the rise of consumerism, competition based on value, and decline of geographic isolation as strategic imperatives. What’s your organization seeing, sensing, and reading about? That does not take a multimillion contract with a Big 8 consulting firm to answer those questions. 

Organizations—small to large–must anticipate and prepare for a future they deem worth pursuing.  This action requires strategic foresight thinking (SFT), another skill not exclusive to expensive consultants.  SFT can enhance the value an organization delivers, enable differentiation, and improve the health of the community and population.1,2

It takes commitment and a champion willing to start a GROUND 0. Health futuring has the potential to provide health organizations with options for viable change and creating a preferred future using the strategic foresight thinking techniques of:

  • GROUND 0: Plan-to Plan – Most important! 
  • Scanning and monitoring the environment for driving forces
  • Analyzing internal and external assumptions
  • Creating multiple scenarios around emerging issue and initiative areas
  • Developing forecasts
  • Writing actionable outbriefs with solutions, initiatives, and responsible leaders
  • Assuring program champions, teams, and members are ready to seize the future
  • Using the results of futuring to inform, inspire and engage in tremendous improvement.

Let’s have the courage and ambition to challenge yesterday’s healthcare logic—episode of care production over community health and value, sick care over preventive care, provider versus patient-centered (and responsible)–and adopt strategic foresight thinking techniques to create the most reliable and innovative health system with the healthiest population in the world!

Embrace Strategic Foresight Thinking (SFT)

“Organizations have complex, well-developed immune systems, aimed at preserving the status quo” ~Peter Senge

Health futuring is strategic foresight thinking (SFT) in action. It is a creative decision-making process that leads to planning, programming, and resourcing development. Health futuring looks forward 10, 20, or 30 years, while planning looks ahead 1 to 4 years.1-3  For example, a “-omics” (e.g., genome, proteome, microbiome, exposome, metabolome, lipidome, epigenome, metagenomics, pharmacogenomics) paradigm shift is underway.4  

What if genetic medicine and screening were destined to be common practice within 20 years?  What would you do?  You might answer, “I need more of them” How long does it take to train and recruit, a cadre of geneticists and implement the right technologies? Many estimate it takes 8-10 years to train and geneticist and the 4-5 years to find the capital for resourcing.  You are already looking out 10-15 years with this example alone. Your GROUND 0 Champion can facilitate this way of thinking.

Strategic foresight thinking (SFT) is a means to address the opportunities in a fuzzy future over a long period, then work backward.  SFT is an element of strategic thinking and change management–informs strategy-making, planning, and actionable strategies. SFT does not replace strategic planning. Instead, SFT is integrative and enriches the context within which strategy is developed, planned and executed.

The health futuring champion must be well grounded in SFT—ability be uncomfortable with fuzzy futures, influence others to the same, create a safe and transparent work environment, and confidently communicate the value of thinking 20-30 years into the future.3,5

Steps of Health Futuring

“Lots of discussion about where we could be in the next 5-10 years. The technology exists as does the desire to move from reactive focus (driven by external mandates) to proactive planning and rapid evolution. All the parts and pieces are there, along with a great team …” ~Participant at 2018 Air Force Medical Service Senior Leader Conference

Most organizations have the means and tools–analyzing trends to projecting anticipated futures–needed to implement a health futuring process.  Organizations of all sizes can adopt a framework and steps with in-house resources or a small investment. Health futuring, timely and proactive planning tied to meaningful engagement with teams of leaders will result in a platform for connecting those teams of leaders with the intellectual capital across disciplines to create a preferred future and follow through.  Your GROUND 0 Champion can help you see it.

However, the critical element is the first step in GROUND 0: a strong-willed approachable visionary champion to lead the process and development. The positive benefits of the process include the development of a futuring framework, implementation, and development of actionable recommended courses of action (COA), continuous communication to inform others, and utilization of the framework to develop future leaders who are involved in the process.

The organization’s champion must carefully plan-to-plan. Once GROUND 0 is complete, can begin the health futuring journey and be conducted over some time, conducted in-house or augmented with outside resources, performed by large or small groups, and with a variety of methods.

If you have the courage and ambition to change yesterday’s logic, considered adopting the following steps:

  1. GROUND 0 —Plan-To-Plan and Commit to the Purpose, Relevance, and Value of Health Futuring: Find a committed champion to reinforce a futures orientation! Success at planning for the future requires health organizations to adopt new perspectives–bolder, more creative, dynamic than required in the past. A set of guiding principles or framework will provide the foundation. The champion must work to counter the tendency to overemphasize past and present circumstances by continually pushing their organizations to consider alternative futures different from what they know today. Injecting this style of thinking into healthcare strategic planning invigorates process and leads to thoughtful plans and actionable.1
  • Step 1– Scan and Monitor the Environment: Scanning the environment includes both observational and research-based data in the context of demographic, social, economic, political, regulatory, environmental, and technological changes and opportunities.  The data are analyzed by cross-functional teams using sources such as HealthData.GovRWJF: County Health Rankings and GIS: Dartmouth Atlas of Healthcare for visual insight to support predictions, spot patterns, and act on opportunities. Outputs should be shared as easy-to-understand information of the past trends around real-world health system transformation issues and initiatives. Information should include projections on what may happen and shared with participants to begin converting the information into knowledge. The health futuring champion should invite dialogue to facilitate using the collective wisdom to inform scenarios, forecasts, and outbriefs. Constant scanning and monitoring of the environment identifies the direction of an issue and initiatives-based change and the relevant events affecting changes observed.
  • Step 2–Analyze Internal and External Assumptions: Strategic foresight thinking and decision-making consider external driving forces and internal organizational assumptions related to relevancy, priorities, societal and regulatory trends, as well as the organization’s mission and resource constraints. Assessment of external assumptions involves listening to community-based stakeholders, beneficiaries, and patients—potential partners. For example, in the past social determinants of health have been left to the prevue of community and public health agencies.  A more accurate assumption will be raised more frequently as factors and payment related to population health programs will require health systems to connect with community service organizations to drive better outcomes and better health for at-risk individuals.6
  • Step 3–Create Scenarios around Emerging Issue and Initiatives Areas: Scenarios are stories describing the effects of environmental changes impacting an organization. They are plausible, not probable or preferable portraits of alternative futures. Use of multi source intelligence and results of assumption analysis to develop 3-4 scenarios for each targeted issue and initiative area where change is likely to occur. For example, in 2012, the Robert Woods Johnson Foundation (RWJF) asked the question:  What will health and health care look like in the U.S. in the year 2032?7 Alternative scenarios help leaders understand uncertainties. Scenarios range from a very desirable future to an undesirable or even catastrophic future. RWJF engaged the Institute for Alternative Futures (IAF) to develop a set of scenarios of health and health care in 2032. The purpose was to help health leaders apply a futures perspective and access the kind of creativity and dynamism that can lead to surprising success.7 Develop these scenarios in a written format, and include details. Scenario analysis sensitizes leaders to different possible environments—creative, objective, potential–in ways that traditional graphs and written plans do not it helps organizations prepare the knowledge and means they will need to deal with different futures.1,2  This step should be creative, but by the end of the session, identify the essential indicators of change likely to signal this scenario is likely to occur. A succinct list is most useful.
  • Step 4–Develop a List of “Soft and Hard” Forecasts with Each Scenario: This process represents the “art” of health futuring. What if future battlefield medicine scenarios from above predicted the proliferation of robotic surgeons and crewless vehicles?8  Refer to the data-driven intelligence gathered. Recommended interventions could change the future forecast. For example, the Veterans Affairs’ (VA) National Center for Veterans Analysis and Statistics provides a wealth of “hard” data, information, and projection on veteran’s demographics, disabilities, and injuries.  However, if the VA wants to envision how their medical facilities would take care of future injuries, supporting information from the National Military Strategy and other credible sources would provide additional insight into making plans. Use of technology and future wars in mountainous terrain, use of lasers, or microwaves can temper statistical forecasts. When used with supportive content such as studies and analyses to support scenarios the health organization’s ability to learn from the future today improves.
  • Step 5–Use the Results of Steps 1-4 to Write a Succinct Outbrief With Actionable Solutions: Relatively speaking,it’s easy to plan a futuring event and participate.  It is harder to write a short and compelling out brief. A one-page executive summary enables more significant benefits of the event.  It sustains the momentum. Outbriefs should be available electronically for easy access by participants, staff, and partners. Outbriefs should be searchable and permit users to respond with observations, indicators of change, or “ahha” ideas. Open access enables a learning organization culture of empowerment.
  • Step 6–Assign Outbriefs with Scenarios to the GROUND 0 Champion Most Likely to Notice Indicators and Signals of an Emerging Change: This champion should have selected key players, staff, and partners or “teams of leaders” most likely to have a passion to take immediate action when change is emerging and backcast toward the anticipated change. These “teams of leaders” should take action on the anticipated change begins to occur. For example, Artificial Intelligence (AI) is likely to be commonplace within 20 years.  Now would be the time to begin creating an AI code ethics and brainstorming the possibilities on how to improve health using electronic medical records, registries, and predictive analytics.
  • Step 7–Assign Teams of Leaders Responsibility of Continual Futuring to Engage, Inform, Educate and Resource:  While individuals can prepare for futuring, leaders working with a cross-functional teams are more fully engaged. The teams need to understand the implications of futuring so resources will be allocated when an anticipated future begins to become a reality or create a future reality.

Remember, health futuring is not about forecasting. It is about strategic foresight thinking. In essence, SFT is about using what we know, what we have experienced and what we have felt, and then applying those with different perspectives in mind in the spirit of the above steps.

Expanding the perspectives and contrasts is central to opening up thinking and offering a variety of potential paths of action. It starts with GROUND 0 and your champion.

Deep Dive Questions

These questions encourage reflection on personal leadership styles, organizational strengths and weaknesses, and practical steps for implementing health futuring.

  1. What are the hardest things for your company about adopting a future-focused attitude?
  2. How can you use the different points of view on your team to come up with interesting ideas for the future of healthcare?
  3. What specific things can you do right now to improve your role as a GROUND 0 Champion in your company?
  4. How can you make sure that your attempts to predict the future of health don’t just lead to empty predictions?
  5. How can you get people who don’t like change to accept it and make your group a place where people are always learning and adapting?

Activities For Professional Growth And Learning

These activities provide hands-on learning opportunities for individuals and teams to gain practical skills and knowledge in health futuring.

  1. Go to a workshop or training on health futuring and strategic foresight thought.
  2. Read books and stories about how healthcare, technology, and society will change in the future.
  3. Do a mini-futuring activity with your department or team that focuses on a certain problem or chance.
  4. Get to know other people who are interested in health futures and share the best ways to do things.
  5. Make a learning plan for yourself to get better at planning ahead and thinking strategically.
  6. Hold a “Futures Cafe” workshop to brainstorm future company scenarios with colleagues from different departments. Guide discussion with scenario planning tools like STEEP (Social, Technological, Economic, Environmental, Political).
  7. Assess current strategies, policies, and resources for the future. Find gaps and adaptation opportunities for future challenges and opportunities.
  8. Join a professional community to discuss health futuring with other healthcare professionals. Share tips, learn from each other, and keep up with trends and resources.

Conclusion

“Long-range planning does not deal with future decisions, but with the future of present decisions.” ~ Peter Drucker

Organizations must be more forward-looking to deal effectively and systematically with an increasingly turbulent environment. You GROUND 0 Champion and facilitate the process and dialogue.  If managed correctly, the turbulence can be converted into aspirations and opportunities.

Questioning yesterday’s logic means leaders must constantly be mindful of gaps in their processes, improve their strategic thinking skills, and develop the desire to learn from any source and convert this learning into action. GROUND 0 Champions create safe spaces to make “unshackled” SFT possible. To do so means embracing the steps and techniques of foresight thinking. 

Health futuring, based on a all source driven intelligence system, is key to health organizations remaining relevant, agile, and adaptive. Effective health futuring will lead to:

  1. Higher quality strategic decision-making during uncertainty.
  2. Shift from reactive to agile and adaptive modes to anticipate change.
  3. Effective framing of issues, valuing and ranking of initiatives and priorities.
  4. Align current and future assets to address emerging issues and initiatives.

The consequences of today’s decisions will frame the health organization’s viability for future generations. Let’s have the courage and ambition to challenge yesterday’s healthcare logic—episode of care production over community health and value, sick care over preventive care, provider versus patient-centered (and responsible)9-13–and adopt strategic foresight thinking techniques to create the most reliable and innovative health system with the healthiest population in the world!

Did I hear you say you were going to volunteer to be a GROUND 0 Champion in your organization?

Key Words

Health Futuring, Healthcare Future, GROUND 0 Champion, Strategic Foresight, Future Of Healthcare

Resources

This section offers a curated selection of credible sources for further reading and exploration. By delving deeper into these resources, readers can gain a richer understanding of health futuring and its potential impact on their organizations.

  1. Harris JM. Healthcare Strategic Planning, Fourth Edition. Chicago, Illinois: Health Administration Press (HAP); 2018.
  2. Walston SL. Strategic Healthcare Management: Planning and Execution. Chicago, Illinois: Health Administration Press (HAP); 2014.
  3. Lustig, Patricia. Strategic Foresight: Learning from the Future. Axminster, England: Triarchy Press; 2017.
  4. Bradley E, Taylor, Lauren The American Health Care Paradox: Why Spending More is Getting Us Less. New York City, NY: PublicAffairs; 2013.
  5. Lavizzo-Mourey R. Health and Health Care in 2032 Report. Paper presented at: RWJF Futures Symposium; 2012; Alexandria, VA.
  6. “The Future of Healthcare: A Guide for Strategic Planning” by the Institute for Alternative Futures (IAF): https://ache-cahl.org/storage/2022/07/CAHL_Strategy_in_Healthcare_Dead_or_Alive_Article_Andrew_James_Yevgeny_Orlovskiey_v3.pdf
  7. “Scenarios: The Art of Strategic Foresight” by Michael J. Ringland and Diane M. Schwartz: https://www.amazon.com/Scenarios-Conversation-Kees-van-Heijden/dp/0471966398
  8. “Strategic Foresight in Healthcare: A Practical Guide” by the American Hospital Association (AHA): https://www.aha.org/ahahret-guides/2011-09-16-hospitals-and-care-systems-future
  9. “The Omics Revolution: Genomics, Proteomics, and Metabolomics” by Richard A. Harvey: https://www.amazon.com/Metabolomics-Proteomes-Approaches-Biofertilizer-Industry/dp/9819935601
  10. “Future-Proofing Your Business: 10 Rules for Building Organizations That Thrive in Unpredictable Times” by Gary Hamel and Lowell Bryan: https://quizlet.com/528977208/ba3305-ch-5-flash-cards/
  11. “The Future of Health Equity: A Call to Action” by the Centers for Disease Control and Prevention (CDC): https://www.cdc.gov/pcd/issues/2023/23_0160.htm
  12. “The Future of Health and Health Care in 2032” by the Robert Wood Johnson Foundation (RWJF): https://www.rwjf.org/en/building-a-culture-of-health/focus-areas.html
  13. “Battlefield Medicine of the Future” by the U.S. Army Medical Research and Development Command (USAMRDC): https://mrdc.health.mil/
  14. “The Quadruple Aim: Redefining Healthcare in America” by Donald Berwick, Elaine Bishop, and Michael Berwick: https://www.forbes.com/sites/katiejennings/2023/08/22/amazons-radical-plan-for-healthcare–la-carte-pricing/

These diverse references provide comprehensive insights into health futuring theory, practical tools, and case studies.

About the Author

I am passionate about making health a national strategic imperative, transforming and integrating health and human services sectors to be more responsive, and leveraging the social drivers and determinants of health (SDOH) to create healthier, wealthier, and resilient individuals, families, and communities. I specialize in coaching managers and leaders on initial development, continuously improving, or sustaining their Strategic Health Leadership (SHELDR) competencies to thrive in an era to solve wicked health problems and artificial intelligence (AI).

Visit https://SHELDR.COM or contact me for more BLIP-ZIP SHELDR advice, coaching, and consulting. Check out my publications: Health Systems Thinking:  A Primer and Systems Thinking for Health Organizations, Leadership, and Policy: Think Globally, Act Locally. You can follow his thoughts on LinkedIn and X Twitter: @Doug_Anderson57 and Flipboard E-Mag: Strategic Health Leadership (SHELDR)

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