Access to health care, the quality of care, and rising costs are perennial issues that in recent years have spurred new means of delivering services. One notable evolution has been a shift in diagnosis, monitoring, and treatment from physicians to mid-level clinicians and consumers, offering less costly and more convenient options. Innovative technologies, regulatory changes, and consumer interest are major factors driving this shift. The technologies include simple, accurate, and inexpensive tests and devices for a wide range of medical conditions, and online search, information, and interconnectivity. The trend could potentially increase the health care system's capacity and thereby create greater access to care while reducing costs and improving health outcomes. The shift has important implications for health care providers, payers, device manufacturers, policymakers, and consumers. Among them are the impact on health outcomes, the safety and design of devices, cost and reimbursement issues, and the response of mainstream health care. This report discusses the technologies, regulatory trends, and market forces that are reshaping the way many types of health care are delivered, and what the shift in diagnosis, monitoring, and treatment to mid-level clinicians and consumers means for stakeholders. It also presents key questions for further discussion and research.
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