Health and care are going through a very accelerated phase of change. There are various drivers causing these changes and these are starting to demonstrably exert their influence as well as start to act synergistically. Among these changes:

1. Aging and accompanying multimorbidity, both of which drive increases in activity in existing health and care systems as they strive to manage noncommunicable diseases. This increase in activity puts further financial pressures on these systems which are already “over- trading” and further encourages the adoption of value-based solutions where prevention of disease becomes at least as important as treatment of existing conditions.
2. The explosion of availability of data and the deployment of processes that allow for interoperability. This drives the potential to develop more customized treatment plans for people. This availability of data is likely to be further enhanced once 5G networks are employed and the internet of things enabled.
3. The availability of genomic information around individuals which is becoming more commonplace and enables people to better assess their likelihood of developing disease and thus better target their efforts towards risk mitigation in situations where we understand the pathophysiology of disease and the behaviors we need to adopt to lessen the likelihood of developing these. 
4. The potential for us to be able to measure the epigenetic biomarkers that act as “switches” amplifying or turning off the effect of our genes and the increasing affordability of access to these biomarkers. At present these are mainly concentrated around the cardiovascular space, but no doubt the range will widen as science advances. Also the fact that the cardiovascular contribution to cardio-metabolic disorders is now understood to have an even more ubiquitous role is an added factor to take into consideration
5. The increased understanding around the role of behavioural sciences in the management of risk reduction of noncommunicable disease and the increased ability to access this data on a personalized basis.

These changes are driving a new age in health and care – the age of precision. As health and care systems become more interoperable, and the shift from volume to value starts to become more tangible, there are some aspects of health and care which will inevitably be taking up much more of our attention. Among these are:

• The issue of consent and the coming of age of behavioural approaches to driving better health. The consent of the person is clearly an essential pre-requisite to deploying the emerging solutions developing the whole area of assisting the person to better manage their health and care in the area of health and wellness as well as in more established precision medicine deployments. It is becoming clearer that the well-worn solutions of blanket consent may well not necessarily fulfill the expectations of people in allowing their data to be used and the time has come for us to move to a more dynamic interaction with people, which would include not only the use of gamification to assist in sustaining engagement but also a more dynamic approach to obtaining consent. This is likely to be the place where innovative companies will succeed and those less well-versed in the interface of their technologies with people, will be thwarted in achieving rapid deployment.
• The issue of shared and agreed taxonomy within interoperability. Interoperability is very likely going to remain one of the really hot topics. The delivery of health and care via population health approaches relies on having a single version of the truth and the ability to share data in real time in an intelligible format, also sharing and adhering to some elements of shared customised pathways of care. This remains an enormous challenge politically in every jurisdiction globally and that excludes the technological challenge.
• Workforce and the effect of burnout. Burnout is a global phenomenon affecting every jurisdiction – and solutions to assist physicians, nurses and administrative staff are likely to continue to be developed. This is a specific area of interest for HIMSS as we continue to develop solutions around the change management initiatives associated with digital transformation. We are also likely to see better clinical decision support solutions, particularly associated with deployment of customised pathways and more sensitive to the requirements of clinical pathways
• Acceleration of the technologies associated with the internet of things, the deployment of artificial intelligence, and the use of voice particularly in areas which assist both clinical decision making and annotation of records as well as mechanisms to allow patients to better self care and access digital solutions quickly and effortlessly.

The 2020s are likely to witness the emergence of technologies at far greater speed than we have been used to. Some, not all, will succeed and it would be surprising if health and care in 2025 would be immediately recognizable using the models we have got accustomed to.

As a global not for profit membership organization, HIMSS wishes to be with you all the way along this journey, assisting where possible, and also illuminating excellent practice all over the globe. We all have incredibly challenging times ahead of us as we try to adapt to the changes whilst ensuring we maintain safety and consistent quality in the services we offer. It will be a fast paced and occasionally difficult journey but I feel very confident we will continue to innovate and assist in thought leadership and that together we will emerge stronger.

Dr. Charles Alessi is HIMSS Chief Clinical Officer.

This blog will be published in the upcoming issue of the HIMSS Insights eBook. Healthcare IT News and HIMSS Insights are HIMSS Media publications.