For the Tuesday morning closing keynote at the 2012 ASHE PDC Summit in Phoenix, Arizona, author, consultant, and futurist (and ASHE PDC master of ceremonies) Ian Morrison pulled together the key messages presented throughout the conference into a single unified presentation to create a comprehensive message to attendees with simple, direct takeaways. The bottom line: the U.S. healthcare system must and will change, and there is a great period of opportunity here for those interested in being a part of the future.

After recapping the general points of T. R. Reid's opening keynote, which focused on comparing the U.S. healthcare system model to the four general models used in the rest of the world's wealthy nations, Morrison set up a lenghty explanation as to why the U.S. system--the only one in the world that incorporates all four models rather than focusing on just one--is unsustainable. Morrison defined the value of health services with a simple equation: Value equals (Access + Quality + Security) over Cost. Simply put, the U.S. denominator in that equation--cost--is severely out of whack, as the United States has the highest spend and the worst "mortality amenable to healthcare" of all similar nations.

After painting a rather bleak picture of the current math situation, however, Morrison did provide much reason for optimism for the future. Following the general message of many of the other plenary sessions that took place at the 2012 PDC Summit, Morrison indicated that a move to a population-based payment system is generally the favored outcome, and that changing the delivery model via technology and new models of care will be key to engaging consumers. A change in the compensation principle from being action-based to being outcome-based will be an important change that will go a long way to improving the system overall, as it logically follows that reimbursement changes will change delivery methods by default. Morrison also stressed throughout that changes will come regardless of what happens on the political front, and the ultimate fate of healthcare reform and Obamacare.

Morrison also presented data gathered on his own from polling facility owners and consumers as to what they want and expect from a new system. For facility owners, reducing labor costs to cut overhead can and should be done by redesigning delivery methods. For consumers, an indication that they would trade choice and access for lower premiums further indicates that the cost denominator is what needs fixed first and foremost. His ultimate advice for the nation's hospitals? Get cheaper, get better.

Tying the message back to the A/E community--the heart of the PDC audience--Morrison provided a few guideposts. He stressed a need to design for maximum flexibility in these changing times--but to be cautious about ownership's willingness to pay for said flexibility. He encouraged A/E to think about portfolios and to play out as many alternate scenarios as possible to prepare for whatever comes. He advised to support clinical redesign and to keep sight of the fact that "it's not about boxes, it's about patient solutions," and to picture the situation in terms of rethinking rather than simple innovation.

Ultimately, Morrison concluded that this is a time of great opportunity for all involved in the planning, design, and construction of the nation's healthcare facilities. His final message was to build real teams to do this work, including owners, clinicians, planners, designers, construction, and even regulators, and that it was a must to reduce regulatory clutter and to add value to make things better. And finally, Morrison pointed to the example of the team from the Joplin/Mercy Health Care Campus who had presented a plenary session the day before as a source of inspiration, a great example of all involved coming together under extreme circumstances to triumph in the face of adversity.