Health systems are beset by a host of factors that are eroding the enterprises’ foundation, a phenomenon we call The Big Squeeze. There is general recognition that playing whack-a-mole with systemic problems is not an option. Every project needs to address multiple factors at once, ideally improving efficiency, outcomes, and the overall experience of delivering and receiving care at the same time. But it turns out this is actually a good year to be thinking about how platforms will change the health ecosystem and what niche is best for your enterprise.
Platform solutions have been “the next big thing” for some time, and this year is no exception. McKinsey calls platforms a tool for integration and notes it as a key value proposition for many new entrants. Similarly, PwC notes that platforms are an essential feature of better insights and more seamless care orchestration.1 It is tempting to dismiss the topic as old hat, or perhaps even worse- call it premature. But the IT infrastructure of healthcare incumbents is rapidly approaching a level of maturity that will support significant returns from enterprise-wide platforms. This will enable a focus on both the consumer and clinician experience, care navigation, back-office modernization, supply chain and staffing efficiencies, and streamlined billing.
So what is a digital health platform? This definition, which is very broad, is a good start: “Digital healthcare platforms … are defined collections of applications and technologies used to support the delivery of healthcare services.”2 Others add enabling technologies (like the cloud) to the definition, including some EHR vendors; Cerner, for instance, is embracing cloud to develop digital health solutions for clinicians. But the essence is a focus on supporting the delivery of healthcare goods and services.
The World Health Organization advocates for a platform approach to healthcare that spans beyond a single enterprise.3 Their report credits this approach with enabling a number of improvements to: data quality and trust; overall quality and continuity of care; adherence to clinical guidelines and best practices; and efficiency and affordability through the reduction of duplicative services and better tracking and management of time and resources.
With all the talk about embracing platforms, why do it now? The convergence of a number of factors is creating a (excuse the pun!) burning platform: There is an urgent need for the efficiencies platforms create, demand for the insights (and convenience) is impacting the perception of healthcare as it lags other consumer experiences, competition from outside of healthcare is “more real” with the platform being a tool wielded by many new entrants, and the infrastructure investments that have been made are reaching a level of maturity that makes a full platform possible. As we’ve discussed elsewhere, revenue pressure in the U.S. has only worsened. The tripledemic has led to spikes in care demand, even as hospitals’ operating margins are still negative. Other countries face challenges that aren’t directly financial but that still create pressure on the system. Consumer satisfaction is at an all-time low. In a recent Gallup poll, only 48% of healthcare consumers rated healthcare quality as excellent or good. Ratings among working-age Americans have been on a downward trend since 2012, but this is the first time that more than half of people surveyed felt that overall quality didn’t warrant at least a “good” rating.
There are a few things to keep in mind when thinking about a platform strategy.
Make investments in capabilities that cut across the enterprise. Start by identifying the problems to be solved and prioritize tools that support data integration and insight generation for multiple stakeholders. It can be tempting to build out yet another report to track a new set of KPIs, but it’s far more efficient to build self-service tools that can be used by multiple stakeholders, whether it’s used for scheduling, financial tracking, or throughput analysis.
Look for use cases that maximize network effects. Platforms have network effects that are both inside and outside the enterprise. Like other consumer platforms, more patients (users) means more data which in turn means better models and automation. This is part of the virtuous cycle of increasing benefits for users. Internally, creating an infrastructure that combines data from across the enterprise and a set of analytic tools that multiple functions can use empowers your biggest asset: people. While there may be a handful of use cases at the start, putting the right tools and data in the hands of the people responsible for day-to-day functions will result in a tidal wave of innovative hypothesis testing and solutions.
Take a long-arc view of projects that can also impact health outcomes today. Platforms can improve reach and access to care, improve engagement, and enable more seamless care delivery. But those aren’t the endpoints. The Centers for Disease Control and Prevention estimates that 90% of the U.S.’s annual healthcare spending goes toward addressing chronic conditions. Using those features to improve chronic disease and mental health management can improve health outcomes for people today while also generating data that will improve our understanding of the etiology of disease and key points for intervention.
As pressures on the healthcare ecosystem continue to mount, it's essential to build a cross-functional digital platform that can withstand the inevitable ebbs and flows. This can enable meaningful insights and have tremendous effects on both the delivery and receipt of care, impacting patients and clinicians alike.
- Next in health services 2023: Leading disruption through the downturn, PwC, 2023.
- Alharbi F. The Use of Digital Healthcare Platforms During the COVID-19 Pandemic: the Consumer Perspective. Acta Inform Med. 2021 Mar;29(1):51-58. doi: 10.5455/aim.2021.29.51-58. PMID: 34012214; PMCID: PMC8116074.
- Digital health platform handbook: building a digital information infrastructure (infostructure) for health. Geneva: World Health Organization and International Telecommunication Union, 2020. License: CC BY-NC-SA 3.0 IGO.