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"Platforms" for Accountable Care – A "Must Have", Not Just a "Nice to Have"
Vince Kuraitis JD, MBA
Better Health Technologies, LLC
http://e-CareManagement.com blog
(208) 395-1197
2
Gang of Four
3
A Decade of Opening Up Platforms to 3rd Party App Developers
4
What’s a Platform?
In any platform system, there are three types of components: (1) the complements, which exhibit high variety and high
rates of change over time; (2) the core components, which remain stable as the
complements change; and (3) the interfaces, which are the design rules that allow the
core and the complements to operate as one system. Both the core components and the interfaces are relatively long-lived, hence part of “the platform.”
Source: http://hbswk.hbs.edu/item/6025.html
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Platforms Get Enormous Value From 3rd Party Developers
Adapted from: http://www.smartgridnews.com/artman/publish/News_Commentary/The-Smart-Grid-Ecosystem-What-a-Platform-Approach-Could-Mean-to-Innovation-Security-and-More-1199.html
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Electronic Medical Record (EMR) Functionality1/Value Pre-2009
Ord
er
En
try
Ma
na
ge
me
nt
Re
su
lts
Ma
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me
nt
Cli
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al
De
cis
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Su
pp
ort
He
alt
h I
nfo
rma
tio
n &
Da
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EMR “Products”
Val
ue
Quantity1. EMR functions adapted from DesRoches,C. et. al., C. "Electronic Health Records in Ambulatory Care -- A National Survey of Physicians" NEJM; July 3, 2008
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Electronic Health Record (EHR) Functionality2/Value 2010-2015
Ord
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En
try
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nt
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Ma
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me
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Cli
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De
cis
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Su
pp
ort
He
alt
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nfo
rma
tio
n &
Da
ta
EHR Products/Platforms
Val
ue
Quantity
MU
Sta
ge
1 N
ew
Fu
nc
tio
na
lity
MU
Sta
ge
2 N
ew
Fu
nc
tio
na
lity
MU
Sta
ge
3 N
ew
Fu
nc
tio
na
lity
2. For an explanation and description of Stages 1-3 Meaningful Use (MU) criteria, see
https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp#BOOKMARK6
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Scenario 1:Health IT Platforms3 of the Future
Ord
er
En
try
Ma
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me
nt
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Ma
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Cli
nic
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De
cis
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Su
pp
ort
He
alt
h I
nfo
rma
tio
n &
Da
ta
Health IT Platforms (EHR or other?)
Val
ue
Quantity
MU
Sta
ge
1 N
ew
Fu
nc
tio
na
lity
MU
Sta
ge
2 N
ew
Fu
nc
tio
na
lity
MU
Sta
ge
3 N
ew
Fu
nc
tio
na
lity
Pa
tie
nt
Co
nn
ec
tiv
ity
Qu
ali
ty I
mp
rov
em
en
t
Co
mm
un
ica
tio
n
Pu
bli
c H
ea
lth
Re
po
rtin
g
Re
se
arc
h
Ad
va
nc
ed
De
cis
ion
S
up
rt
Te
leh
ea
lth
Mo
bil
e A
pp
s
Me
d D
ev
ice
C
on
ne
cti
vit
y
Hu
nd
red
s o
f F
utu
re
Ap
ps
3. Health IT platform functions adapted from Mandl, K. and Kohane, I. "No Small Change for the Information Economy" NEJM; March 26, 2009
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Scenario 2:Health IT Platforms3 of the Future
Ord
er
En
try
Ma
na
ge
me
nt
Re
su
lts
Ma
na
ge
me
nt
Cli
nic
al
De
cis
ion
Su
pp
ort
He
alt
h I
nfo
rma
tio
n &
Da
ta
Health IT Platforms (EHR or other?)
Val
ue
Quantity
MU
Sta
ge
1 N
ew
Fu
nc
tio
na
lity
MU
Sta
ge
2 N
ew
Fu
nc
tio
na
lity
MU
Sta
ge
3 N
ew
Fu
nc
tio
na
lity
Pa
tie
nt
Co
nn
ec
tiv
ity
Qu
ali
ty I
mp
rov
em
en
t
Co
mm
un
ica
tio
n
Pu
bli
c H
ea
lth
Re
po
rtin
g
Re
se
arc
h
Ad
va
nc
ed
De
cis
ion
S
up
rt Te
leh
ea
lth
Mo
bil
e A
pp
s
Me
d D
ev
ice
Co
nn
ec
tiv
ity
Hu
nd
red
s o
f F
utu
re A
pp
s
3. Health IT platform functions adapted from Mandl, K. and Kohane, I. "No Small Change for the Information Economy" NEJM; March 26, 2009
10
Platforms in Health Care:A “Nice to Have” or a “Must Have”?
• Under what conditions could you believe that health IT “products” are sustainable?– That one company can develop all needed functionality
(apps), and– That Health IT will become a winner-take-all market
• Single payer, or
• One vendor’s product adopted by (practically) all providers in a regional market
• Not likely. Interoperable platforms are a “must have”.
11
Implications?
• Care providers: recognize inevitable migration beyond an Enterprise EMR
• Health plans:– Evolving business strategies dependent upon
availability of clinical data and analytics– Achievable without platform architecture?
• Investors: anticipate inevitable disruption of current HIT architecture; issue is when, not whether
12
Explore the evolution of platform architecture, business ecosystems, and clinical care delivery
Attend in-person or via webinar: http://himssconference.org/ecollaboration/default.aspx