History repeats. Sort of.

Merriam-Webster offers one definition of revolution as “a sudden, extreme, or complete change in the way people live, work, etc.” That sounds pretty darn close to what hospital and health system leaders — including board members like yourself — are dealing with right now, doesn’t it?

In this issue of Trustee, we have articles that support the notion of a health care revolution today — and one article that provides a more surprising perspective.

The cover story looks at something called consumer segmentation, long practiced in the retail world and now gaining traction among health care providers as the trends of population health, patient engagement and consumerism converge. Consumer segmentation goes beyond traditional means of identifying patients by insurance status, risk stratification and so forth. Now, providers are analyzing data from a variety of previously untapped sources, including patients themselves, to customize care delivery. Lola Butcher’s article profiles several provider networks that are taking very different but equally, can we say, revolutionary approaches.

The Executive Briefing outlines six principles hospitals should use to create a “foundational strategy” as they face dramatically new payment systems. And the “Safer, Smaller, Smarter” feature considers tech trends and the role trustees play in helping their organizations make the most of sometimes disruptive information technology breakthroughs.

Then there’s an article titled “History Lessons” in which Jim Rice, a governance professional, describes how the earliest hospital trustees in our nation — or, rather, what would soon become our nation — grappled with some of the same challenges you and your board grapple with today. After an in-depth review of accounts by the first board of Pennsylvania Hospital, Jim came up with five insights he says are “particularly relevant to today’s trustees as they navigate the challenges of population health management and accountable care for their communities.” It appears that today’s revolution isn’t the first one to roil American health care.