Bristol-Myers Squibb’s Opdivo broke new ground in 2015 with a DTC spot for an oncology therapeutic. 

As someone who’s been in the business of healthcare marketing for more than three decades, I’ve seen major disruptions in the field.

In the face of these changes, the recipe for success and growth over this time is the ability to stay alert to what’s going down and to prepare and plan for the events you think will impact our business most. To that end, one of the biggest factors impacting healthcare marketing in mid-2016 is the rise of the well-informed consumer. This is, in part, the result of the Affordable Care Act, which has caused massive shifts in the landscape that are already being felt throughout the system, and, in part, the mass migration of patient information to electronic health records.

To demonstrate how dramatic these factors have been in impacting patient behavior, I can simply look back at the history of our agency. Over the past decade, we’ve worked on a handful of different products in the cholesterol space. Ten years ago, only a small number of patients knew their cholesterol numbers; today, upwards of 35% do.

See also: How Obama’s Precision Medicine Initiative will Change Healthcare Marketing

That number can — and will — get better over time, but it’s symptomatic of patients learning more about their diseases and taking responsibility for their treatment. The key insight for 2016 is that we, as marketers, need to up our game in communicating to patients.

Bristol-Myers Squibb’s Opdivo, for example, broke new ground in 2015 with a DTC spot for an oncology therapeutic. To make that investment, the company had to be counting on a more sophisticated patient (and caregiver) taking note of a major change in the marketplace — namely, a new product offering survival benefits to second-line lung cancer patients.

Another factor affecting healthcare marketing is a shift by physicians from self-employment to hospital employment. That shift fundamentally alters their ability to communicate with the industry. One result of this shift — which I do not believe was intended or widely anticipated — is that some 30% of the physicians in the U.S. sold their practices, which in turn commensurately reduced the number of physicians who are willing and able to be called on by sales reps. That reduction has a profound effect on the day-to-day lives of the 81,000 pharma reps in the U.S.; it similarly affects non-personal promotional vectors, like e-detailing.

See also: What It Will Take to Make Pharma Consumer-Centric

A third factor is the plethora of emails, pop-up ads, and other communications that are now an accepted part of an Internet-savvy life. A physician friend working in a hospital was recently blocked from the online viewing of a new disease-state campaign in the cardiovascular space. New products, it seems, are becoming the healthcare industry’s porn.

I suppose I’ve learned to roll with the punches. Nonetheless, there’s no question that the ability to take a wide-angle view of how healthcare has changed (and will continue to change) and plan for the future, to look in the rear-view mirror to clearly understand change, and to use every single resource in your toolbox to meet these challenges head-on will keep us ahead of the curve. Are we up to the task?

Jay Carter is SVP and director of strategy services at AbelsonTaylor.