Good grief. Such a time we're having. Uncertainty is everywhere about almost everything. We're living with one business model while preparing for a new one, and we're not even 100 percent certain what that new one is.

And if that's not enough to worry about, the existing system is caught up in an anxiety-fraught external financial deficit environment that we can't do much to control.

If I allowed overused analogies to run amok, I'd say we have one foot in the boat, the other on the dock, and now everything has turned into a burning platform. That sounds like a really uncomfortable sea change. (I'll stop there, although I'm dying to say something about herding cats.)

But then health care always has been a pretty disruptive environment in which to manage, much less demonstrate leadership. It's been a jarring bumper car career ride for sure. From DRGs to so-called managed care to the Balanced Budget Act to tiered hospitals to maybe health care reform to "information technology is everything" to actual potential health care reform, many a moon has come and gone since anyone in health care leadership—or stewardship for that matter—could just get in the car and drive down the road and know for sure what was at the end of the trip and the best way to get there.

When we look for the next big marketplace pothole, we line up the usual suspects—government, physicians, insurers, that other guy across town—and assess all the possible twists and turns. But we also know that disruption can just as easily jump out at us from surprising places. For example, what's that ringing in your pocket?

Yes. We love our smart phones. We take them everywhere. We risk life and limb texting while walking. We irritate colleagues, friends and loved ones by paying too much attention to our phones at the wrong place and time. In many cases, our smart phone obsession is the only thing we have left in common with our children. But a growing number of intelligent and perfectly sober people think that these little glowing devices are the next market "revolution" in health care.

In fact, mobile phones have held a very important place in the delivery system for some time. In many Third World countries, smart phones are the delivery system; they save and improve the lives of countless people. I hesitate to mention this since most Americans don't even want to hear about Canadian health care, never mind the Third World, but many innovative and inexpensive mobile models exist.

More importantly here, consumers are tending toward smart phones as an access point to health care, wellness and managing conditions. There is a lot of good news in all of this. Think of reducing costs, managing patient populations and tracking patients across the continuum. Oh, and did I mention that physicians love the iPad? I'll bet you never look at your phone the same way again.