A recent study in JAMA Internal Medicine reported on the diagnostic accuracy of physicians vs. computer algorithms. The study compared the performance of one computer symptom checker app to the text based answers of 234 physicians, 90% of whom were general internists. You can read a summary here.
Writing in Vox, Sarah Kliff describes VC-backed health plan Oscar’s latest twist on strategy:
Oscar’s hope is that it can take narrow networks to the next level; rather than simply cutting costs, Oscar wants to use a narrow network to improve patient experience by deeply integrating with the hospitals and doctors it works with.
Is this the right strategic approach for Oscar? It depends.
I am constantly surprised by the number of companies that intentionally describe themselves as the “Uber of Healthcare”. If you hear me describing your company that way, I don’t mean it as a compliment. What I do mean is some combination of:
Your ethics and values are dubious
Your swashbuckling disregard for regulatory boundaries is backfiring
You underestimated the competition
Your network effects are overstated
Your platform governance model is Medieval
Your business model is unproven
Your valuation is inflated
Let’s take a more detailed look at each of these seven criticisms. Drawing on my background of 30 years in healthcare, I’ve included examples specifically directed at companies describing themselves as the “Uber for Healthcare”. However, I hope you’ll find the analysis applicable to a much wider range of companies that have described themselves as “Uber for X”.
Healthcare has been a laggard in adopting platforms…
…but that’s rapidly changing. In fact, I’ll suggest that healthcare will become the PINNACLE platform industry.
Many value propositions are very strong — literally “life-or-death”.
Acute and episodic care has focused on relatively discrete, time-limited events; the emerging model of chronic care and population health requires ongoing collaboration among care providers and patients.
Many of the value propositions of digital health are dependent upon development of interoperable platforms. For example, non-interoperable platforms would NOT work for:
The patient who shows up unconscious in an emergency room away from home
Patients with chronic conditions who are treated by multiple providers, multiple lab and imaging centers, and over a long period of time
Referrals to specialists using non-standardized, proprietary health IT
The healthcare data explosion. Think “omics”.
Healthcare has much to learn from platform development in other industries…and you can take a deep dive into platform strategies at the upcoming MIT Platform Strategy Summit, July 10 in Boston.
I’ll be chairing a panel on “Healthcare’s Digital Revolution: Emerging Platform Leaders”. The distinguished panelists are:
Michael Salerno – EVP Cohealo
Julie Yoo – Co-Founder & Chief Product Officer, Kyruus
Mark Dudman – Senior VP, NaviNet
Michael Jackson – GM, Intel Corporation
Other speakers at the event include:
Paul Daugherty – CTO, Accenture
Geoff Parker – Director, Tulane Energy Institute / MIT
Chet Kapoor – CEO, Apigee
Sangeet Choudary – Founder, Platform Labs
Luis von Ahn – Founder, DuoLingo & MacArthur Fellow
Malcolm Frank – CSO, Cognizant
Jerry Wolfe – CEO, Vivanda
Chris Dellarocas – Chair Digital Learning Initiative / BU
Eddie Hartman – Founder, LegalZoom
Youngcho Chi, EVP Corporate Strategy, Samsung Electronics
Marshall Van Alstyne – Professor, Boston University / MIT
JP Rangaswami – CDO, Deutsche Bank
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 to interoperability, and describes steps the federal government and the private sector can take to deter this conduct.
We were struck with two major reactions to the ONC Info Blocking Report:
It’s a solid double: it does a credible job of recognizing that the major problems of interoperability and blocking are not technical or due to a lack of standards, but rather due to business practices and business models. The report also proposes a baseline of potential solutions.
It’s not a home run: the report misses the opportunity to describe a comprehensive approach to combat information blocking.
In turn, we offer seven recommendations to strengthen the report:
Place Greater Weight on Patient Safety and Public Policy Concerns
Lower the Burden of Proof For Information Blocking
Put Criminal Penalties On the Table
Broaden the Scope of Tactics for Addressing Information Blocking
Emphasize Federal Purchasing Power — Not Regulatory Power — to Address Information Blocking
Place Less Weight on the Interests of EHR vendors
Name Names, Shine the Light
Where’s the Evidence that Hoarding Data is a Good Business Strategy?
Dear Hospital CIO/CEO,
So you think that hoarding patient data is a good business strategy? …that it discourages patients from going to another hospital?
So why is the marketing department buying billboards encouraging patients to switch for convenience? to save a few minutes?
Tax-exempt hospital systems without fortress balance sheets and top quartile operating performance will be capital constrained in the future healthcare economy, even if tax-exempt debt continues be cheap and accessible. Stating the obvious: operating a hospital is a capital intensive activity. Historically, hospitals have required about $1 of invested capital to generate $1 of hospital revenue. As hospital systems contemplate changing their facility-based fee-for-service models into health enterprise models responsible for managing populations of patients and being at risk, capital will need to be deployed into new areas….
For less than top tier rated hospital systems, these capital demands create a capital conundrum: building both balance sheet strength in the form of increased days cash on hand and reduced leverage, while also spending capital that is not financeable with tax-exempt debt and very difficult without extraordinary operating margins.