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Background:In October 2013, the Public Health Informatics Institute (PHII) and Institute for Alternative Futures (IAF) convened a multidisciplinary group of experts to evaluate forces shaping public health informatics (PHI) in the United States, with the aim of identifying upcoming challenges and opportunities. The PHI workshop was funded by the Robert Wood Johnson Foundation as part of its larger strategic planning process for public health and primary care.Workshop Context:During the two-day workshop, nine experts from the public and private sectors analyzed and discussed the implications of four scenarios regarding the United States economy, health care system, information technology (IT) sector, and their potential impacts on public health in the next 10 years, by 2023. Workshop participants considered the potential role of the public health sector in addressing population health challenges in each scenario, and then identified specific informatics goals and strategies needed for the sector to succeed in this role.Recommendations and Conclusion:Participants developed recommendations for the public health informatics field and for public health overall in the coming decade. These included the need to rely more heavily on intersectoral collaborations across public and private sectors, to improve data infrastructure and workforce capacity at all levels of the public health enterprise, to expand the evidence base regarding effectiveness of informatics-based public health initiatives, and to communicate strategically with elected officials and other key stakeholders regarding the potential for informatics-based solutions to have an impact on population health.

Anticipatory democracy involves enhanced participation in shaping the future. Foresight involves applying futures tools to decision making. The Institute for Alternative Futures (IAF) over its four decades of work with communities, governments, and companies has evolved its “aspirational futures” approach that calls for creating expectable, challenging, and visionary scenarios and using these to enhance vision and the creation of preferred futures. Jim Dator’s approach to scenario development was IAF’s starting place. IAF has supported foresight in executive, legislative, and judicial branches of government, with the largest companies and nonprofit organizations, across six continents. Humanity is maturing, and the values of equity and inclusion are rising globally. Economies are transforming, including major job loss to automation and “abundance advances” technologies that provide low cost energy, 3D printing and local manufacturing, and home and community food production that have the potential to lower the cost of living. Foresight must be applied to understand and help create equitable and sustainable futures using these abundance advances in a transformed economy.

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