Aanvullend menu

The impact of disruptive citizens on health care

In parallel with the ongoing disruption in the market, I pioneered the concept of ‘disruptive citizen’ to draw attention to the impact of the same technological revolution on politics and public services. It leads to new power through information, communication and media and a totally new mentality of self-knowledge, self-steering and self-management of citizens. It already initiated a disruption of democracy as is shown by the victories of both Trump (USA) and Macron (France). The main impact on health care is fivefold, as I lectured about recently in Sweden on the Strategic Health Forum: 1) Patients gather independently of docters information and medical knowledge and claim direct access to their own personal medical files, 2) Patients are choosing between health care providers and even individual medical professionals, based on peerreviews, platformreferences and public data, 3) Patients claim a say in diagnosis, shared decision-making and co-producing in their treatment, 4) Patients want to manage the logistics and planning of the total chain of health care from home to institutes and vv. they are provided with, choose among and add themselves, 5) Patients pioneer and participate in collective organizations of health care provision or matchingplatforms, sometimes outside, sometimes in partnership with official health care providers.

It is a misunderstanding to think that it is only a technological revolution that is going on. It’s most of all a revolution in power and mentality. The impact of the disruptive citizens is heaviest on cultures, structures, routines and ways of handling in the public sector, especially, as it was in the market, on the incumbent powers, elites and executives.

The only element that has saved the public sector thusfar from the same disruption as in the markets is their natural protection by laws, public financing, political support, succesful lobbies, legally established semi-monopolies or special licenses. That will change soon, because citizens learn these powers and expectations already by their new technological tools and the platforms that give them the power of information, communication, choice and public debate and influence. Because of this powerful direct approach of citizens to the public and public debate, the medialandscape already has fundamentally changed by introducing an influential direct channel between citizens, that can and increasingly is used for a bigger audience. This also means the end of traditional political networks and its lobbies, because it will have a direct influence on the chances for re-election of incumbent politicians.