According to Bain, seven of the 10 largest companies in the world are powered by platforms, which host interactions and transactions among corporate or personal users. The same cannot (yet) be said for the health care industry, where point-to-point, manual interactions among disparate entities remain common.
Platforms have been a hard sell in health care for many reasons, according to health care experts at the recent MIT Platform Strategy Summit. The industry is fragmented, complex, and highly regulated. The pricing model is opaque, and the economic incentives are misaligned. Care delivery is episodic, which is difficult for anyone managing a chronic condition. And the industry’s journey to technology adoption has been 25 years in the making. But this is changing.
“Health care is beginning to understand the economic power of platforms, especially in a data-rich environment,” said Randall Williams, M.D., managing director of the consultancy Digital Care Advisors. “The industry is in an early phase of experimentation.”
Williams and other speakers discussed how four major trends are driving platform adoption in health care — and how they’re transforming everything from staffing to scheduling to managing care.
Trend No. 1: The flywheel effect
Simultaneous developments are motivating health care organizations to look at platform technology, said Vince Kuraitis, principal and founder of the digital health consultancy Better Health Technologies. They include: The push for value-based care, the movement toward consumerism, the federal mandate for interoperability, and the expansion of virtual and home-based care models.
Each of these four movements benefits from a variety of overlapping platform capabilities, including data sharing, care coordination, shared workflows, and analytics. As health systems or insurers adopt a platform model to support a value-based care model, the same platform capabilities can drive consumerism, interoperability, and virtual care.
This is an example of the flywheel effect, Kuraitis said — where a small push has a larger impact over time.
“These trends continue to feed the need for adoption of platforms," Kuraitis said.
The impact is heightened when the incentives among platform participants are aligned, said Susan Woods, M.D., founder and CEO of remote patient monitoring firm Generated Health.
“It’s not just about what the patients want, but also what the clinicians want," Woods said.
One example is nutrition advice. Many patients want this, but many physicians received limited training on this topic in medical school, she said. With a platform in place, it’s easier for a physician to recommend a nutritionist (or a vetted and approved nutrition app) to any patient who asks.
Trend No. 2: Increased investment in digital health
According to the consultancy and venture fund Rock Health, 2021 was the biggest year ever for digital health investment. The $29 billion raised nearly doubled the previous high of $15 billion in 2020. Platforms account for about 40% of this investment — and they’re valued at 2.8 times more than nonplatform startups, research from Summit Health showed.
Investors poured $29 billion into digital health initiatives in 2021, according to consultancy and venture fund Rock Health.
While the venture capital market has cooled a bit this year, Williams pointed to recent large-scale investments from big technology companies as a sign of optimism — namely, Microsoft’s nearly $20 billion acquisition of voice tech company Nuance last year and Oracle’s $28 billion acquisition of electronic health record giant Cerner earlier this year.
“Big tech is sitting on nearly half a trillion in cash available to invest in the digital assets of health care,” he said. “Clearly, the foundation has been laid for platforms to emerge.”
Adam Grossman, partner at investment firm Deerfield Management, sees these platforms emerging in many parts of the health care ecosystem where matching has typically been difficult: Finding staff to cover a shift, finding doctors with appointments available, finding patients for clinical trials, and so on.
Still, change can be hard, Grossman said. Many physicians — including his own — are more comfortable making referrals to specialists they know personally than logging onto a platform that connects them to other specialists.
“Referrals are usually relationship-based," Grossman said. "That’s a hard behavior to break.”
Trend No. 3: New data models
Along with making acquisitions, big tech vendors are among the companies leading the charge to adopt Fast Healthcare Interoperability Resources, a standard for data exchange that uses application programming interfaces to enable systems built by different vendors to share information. Fueling that charge: the government is requiring health IT vendors to make a certified, FHIR-enabled API “endpoint” available to their customers by the end of 2022.
This shift in data access and availability enables health systems to get a more complete view of their patients, Williams said. While on-premises clinical applications are limited to the information they’ve stored about appointments that occurred in that building, platforms offer the ability to obtain and integrate data from external sources.
In this environment, Williams said, “Every health care organization should be thinking of itself as a digital platform. If you’re required to use APIs, that effectively makes you a platform.”
The combination of activity from big tech and a government mandate has also had a trickle-down effect on digital health platform startups, which are making their data available using FHIR APIs, said Suchi Saria, Ph.D., founder and CEO of AI platform Bayesian Health.
“Five years ago, this was extremely hard. Now, you can engage with multiple partners to connect and meaningfully stitch data together and build high-quality information out of it,” she said. “It’s an enormous opportunity for using the right kind of machine learning tools to learn from messy data sets. Instead of traditional experiments in the lab, you’re able to learn in the wild.”
Trend No. 4: A more competitive landscape
In the traditional model of care delivery, the provider serves as the gatekeeper for any medical services a patient may need, Williams said. Platforms put a range of virtual, in-home, and in-person options into the patient’s hands.
This can be valuable for people managing chronic conditions. Bobby Sepucha, CEO of Cricket Health, a platform for managing chronic kidney disease, noted that patients benefit from a care experience that’s less transactional and more ongoing. As patients use the digital platform to keep track of vital signs, start a new medication or treatment, and make diet and lifestyle changes, they benefit from interacting with a provider every few days, not just every few months.
“We want to create an environment in which patients can immerse themselves in information about their disease state and have access to a dedicated care team,” Sepucha said. “How do you flip the care model so these patients engage with their care team when it’s convenient for them, and not convenient for the care team?”
If this type of care model succeeds, brick-and-mortar health systems may see their business model “under siege,” Kuraitis said.
The future care delivery model could look something like Ping An Good Doctor. This Chinese platform combines medical and pharmacy services with health care information, insurance offerings, and financial services. In 2021, PingAn had 1.3 billion consults — compared to 15 million for Teladoc Health, the largest virtual care provider in the United States.
Though health care stakeholders will face an uphill battle to transition to the platform model, Kuraitis said he sees health care as the “pinnacle platform industry” within the next decade. The strength of the value proposition is the primary reason why: “We’re saving lives. We’re eliminating human pain and suffering.”