Disruptive Dose: R.J. Lewis on AI, Publishing, and the Future of Evidence
September 2025 — Digital Health Coalition
In a wide-ranging conversation with Mark Bard, Co-Founder of The DHC Group, R.J. Lewis, Founder, President, and CEO of e-Healthcare Solutions, shared candid insights into how artificial intelligence is reshaping publishing, physician engagement, and the broader digital health ecosystem.
AI’s Impact on Publishing
Lewis highlighted the profound disruption AI poses to publishers. As models ingest vast amounts of human knowledge, including content once gated behind firewalls, publishers are facing what he described as an “existential risk.”
“Every publisher we spoke with said the same thing: AI is an existential risk to their business,” Lewis emphasized.
The economics are shifting rapidly. Traditional publishing models that relied on search-driven traffic and ad revenue are already under pressure, with commercial publishers seeing drops of 40–50% year over year. Societies and associations fare slightly better but still face double-digit declines.
Lessons from the Music Industry
To explain the trajectory, Lewis drew a parallel to music. Once dominated by direct-to-consumer sales and independent artists, the industry was transformed by aggregators like Apple Music and Spotify.
“Maybe the Spotify of today is the open evidence of tomorrow,” he suggested, noting that consolidation or absorption by hyperscalers may be inevitable.
The analogy illustrates both opportunity and risk: just as aggregators reshaped music distribution, AI-driven evidence platforms could redefine access to medical knowledge.
The Future of Evidence Access
Lewis pointed to “open evidence” as an early vertical model that may set the stage for broader adoption. While not yet a major financial engine for publishers, licensing agreements with large language models (LLMs) could provide new revenue streams — if publishers act quickly.
Subscription models, too, may resurface as a way to protect and monetize valuable content. “If you truly have unique content,” Lewis noted, “subscription revenue is a good way to do it. Publishers may even charge LLMs directly for access to archives or premium material.”
What’s at Stake
For physicians, the disruption has clear benefits: faster, deeper, and more accurate answers at the point of need. But for publishers, the stakes couldn’t be higher. With search traffic already under siege, Lewis warned that advertising models will need to be reimagined — especially as LLMs and AI interfaces replace traditional search engines.
“The future is radically different, but it’s unevenly distributed,” Lewis said. “Some are going to take big hits, while others may find new paths forward.”
Moving Forward
Despite the challenges, Lewis underscored that adaptation is possible. Publishers who rethink access models, embrace subscriptions, and negotiate licensing with AI platforms may find sustainable business models. Those who don’t risk being left behind.
The conversation closed with a reminder: just as media, music, and news organizations were upended by digital platforms, the healthcare publishing world now faces its own moment of reckoning.
The question is no longer if disruption will come — but who will define the new model of evidence in the AI era.
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