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EHR
The New Rules of Healthcare Platforms: APIs Enable the Platforming of Healthcare
by Vince Kuraitis, Brendan Keeler, and Jody Ranck
Recent regulations have mandated the use of HL7 FHIR APIs (application programming interfaces) to share health data. The regs apply to healthcare providers, payers, and technology developers who participate in federal programs. Many incumbent healthcare organizations are viewing these mandates as a compliance burden. That’s short-sighted. We recommend a more opportunistic POV.
APIs facilitate the sharing of health data across different devices and platforms. By adopting APIs, healthcare organizations can transform themselves from traditional service providers into powerful platforms that can connect patients, providers, and other stakeholders in new and innovative ways.
This blog post is the fourth in the series on The New Rules of Healthcare Platforms. In this essay, we explore the many benefits of API adoption for healthcare organizations and the key considerations that must be taken into account when implementing APIs:
- Healthcare’s Data Inflection Point
- APIs Enable Platform Business Models
- Barriers, Challenges, Reality Check
Today’s Patient Portals CAN NOT Work: An Inability to Capture Network Value
by Vince Kuraitis JD/MBA and Jody Ranck DrPH
Today’s patient portals are a mess. The catchphrase “Your mom has 7 portals for 7 providers” sums up patients’ frustrations and the resulting tepid utilization of portals. Today’s portals CAN NOT capture network value.
The first post in this series introduced the platform terminology of single-homing vs. multihoming. Patients strongly would prefer to have as few portals as possible — ideally one, i.e., a single “home”. However, patients are forced to subscribe to multiple homes since today’s portals are tethered to individual institutions or care providers.
In this post, we’ll introduce the platform terminology of stand-alone vs. network value. Today’s patient portals can provide some stand-alone value, but they provide minimal network value.
In the upcoming third post in the series, we’ll discuss “friction” in today’s portals. In the fourth post, we’ll consider some alternatives; while today’s portals CAN NOT work as configured, we’ll look at some options that could work.
Stand-Alone vs. Network Value
Value is created in different ways for different offerings. Some offerings provide stand-alone value; others provide value through networks and networked data and activities; some provide a combination of these.
Stand-alone value refers to the value provided by an offering that is independent of how the platform is used by others. Network value refers to value created through the activity and usage of others. Network value also refers to network effects or positive feedback loops created through the activities of others.
Let’s use your personal computer as an example to explain the difference between stand-alone vs. network value. Your PC has stand-alone value even when it is not connected to a network such as the internet.
Platform Terminology Explains Why Today’s Patient Portals CAN NOT Work
“…the patient portal, as currently architected, is a complete dead-end.”
—John Moore, Founder and Managing Partner, Chilmark Research
Patient portals have tremendous potential — but that potential has not been realized and *CAN NOT* be realized as portals are currently configured.
An understanding of platform business models and strategy explains why today’s patient portals are inherently suboptimal.
This essay is the first in an occasional series that will look at patient portals through the lenses of platform business models and strategy. Today’s post will introduce and explain platform terminology of multihoming and single homing. Future posts will look more deeply into “why” current patient portals can’t work and will propose options for portals that could work for patients.
Briefly Characterizing Today’s Patient Portals
Chilmark Podcast–Platform Thinking for Healthcare: A Discussion with Vince Kuraitis and Randy Williams
Dr. Randy Williams and I were interviewed by Jody Ranck of Chilmark Research. We discuss platform thinking for healthcare. Chilmark’s article contains a link to the podcast, a summary, and an “AI-generated” transcript.
Here are a few choice quotes from the podcast:
Vince: “EHRs are the poster child for a lack of platform thinking in health care”
Randy: “traditional business models really produce products and services, and they do that through taking the production side, integrating that and ultimately selling and delivering a product or a service to a customer….platform businesses really contrast with these traditional pipeline businesses by unlocking new sources of value both on the creation side of a transaction but also on the consumption side. Their function is really to facilitate matches or to consummate exchanges of goods and services, thereby creating value for all the parties.”
JAMIA Study Reports 22-68% Interoperability Across EHR Platforms: 7 Implications
by Vince Kuraitis, JD and Ian McNicoll, MD
A recent study of EHR interoperability found that 68% of data was “understood” when exchanged across different sites using the same vendor, but only 22% was “understood” when exchanged across different EHR vendors.
The study was published in the Journal of the American Medical Informatics Association (JAMIA). In this post, we will:
- Summarize the JAMIA study and its findings
- Interpret the findings
- Discuss possible solutions
- Describe seven implications
While we mostly agree on the study’s findings, we’ll offer some nuanced interpretations. Vince is a U.S. based healthcare consultant focusing on platform strategy and business models. Ian brings a European perspective – he is a former Scottish GP turned medical informatics expert.
Will Google Health Platformize the Electronic Health Record Market?
by Vince Kuraitis, Edward G. Anderson, and Geoffrey Parker
The COVID-19 pandemic has accelerated calls for the development of EHR 2.0 (electronic health record 2.0) – the next generation of EHRs with extended platform features and capabilities.
Who will answer this call? While existing EHR vendors have made modest efforts, the door is open for big tech companies and start-ups to develop functionality to envelop and disintermediate current EHRs. We highlight early efforts by Google Health Care Studio as having the potential to bring platform functionality to a sector of the healthcare industry known for resistance to change and innovation.
Read the full article in The Health Care Blog.
ONC Report on Health Information Blocking: A Solid Double, But NOT a Home Run
A Stand Up Double
By Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA
Last Friday ONC (the Office of the National Coordinator for Health IT) released a long-awaited Report On Health Information Blocking. The ONC blog capsulizes the report:
Health information blocking occurs when persons or entities knowingly and unreasonably interfere with the exchange or use of electronic health information. Our report examines the known extent of information blocking, provides criteria for identifying and distinguishing it from other barriers […]
Open.Epic: A (Not So Open) API
Last week EHR vendor Epic unveiled it’s new API (application programming interface) targeted at developers — more specifically at remote patient monitoring companies and health/wellness apps or portals. Epic seems to have had second thoughts about the site since only remnants of the landing page are still there as of today.
The EHR|HIE Interoperability Workgroup — Potentially Earth-Shattering
Yesterday’s announcement of “Standard Health Data Connectivity Specifications” by the EHR|HIE Interoperability Workgroup (EHR|HIE WG) is potentially earth-shattering.
My mom would not know what I mean by “Standard Health Data Connectivity Specifications,” so I’ll try to write this in plain English.
Who Are These Guys? The EHR|HIE Interoperability Workgroup
The workgroup consists of HIEs (Health Information Exchanges) representing seven of the largest states, eight EHR vendors, and three HIE software/services vendors.
Through the Lens of Disruptive Innovation: Why Direct is a Hit and PCAST is an Outcast
(click on the graphics to link to original sources)
Regular readers know that I find Professor Clay Christensen’s theory of disruptive innovation to be a useful lens to explain industry evolution. Let’s look at two recent health IT initiatives and see why one is working and the other is stalled.