What Types of Business Models are Commanding the Highest Valuations? Implications for Healthcare?

valuationQ. What Types of Business Models are Commanding the Highest Valuations?

A.  “Network Orchestrators”

Source: Dion Hinchcliffe, presentation at Salesforce Dreamforce conference, October 14, 2014

Where are there opportunities for “network orchestrators” in healthcare?

• ACOs
• Patient centered medical homes
• High-value health insurance networks
• Care management/population health management vendors & implementers
• Health information exchange networks
• …many others

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Will Apple’s Strategic Beachhead Be Doctors, Not Patients?


Last week Apple held a huge media event to announce forthcoming products, including the iPhone 6, 6+ and Apple Watch.  Many of us in the healthcare world had been sitting on the edge our seats, hopefully awaiting news detailing Apple’s broader strategy in entering healthcare.  We were disappointed — no mention of Apple HealthKit, no doctors on the main stage, only a few teasers about how the Watch might be used in fitness and health monitoring.

Apple is a consumer technology company, and it’s natural to think that their efforts in healthcare will be aimed directly at patients.  However, I’ve been pondering whether that’s looking at Apple’s opportunity through the wrong end of the telescope.

Are physicians — 85% of whom own an iPhone — a much more natural and powerful strategic beachhead for Apple to focus on?

Our focus has been to figure out how to accommodate the 5% of patients that get their peace of mind knowing that they have absolute control of every piece of their data. Our focus really should be on the 95% that get their peace of mind knowing that when they show up in the ER, all of their data will be there.

Lawrence Garber MD, Internist/Medical Director for Informatics, Reliant Medical Group. Comment at ONC JASON Task Force, July 2014.

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Patient Digital Health Platforms…A First Take

This post was originally published on the HIMSS blog with the title “Patient Digital Health Platforms (PDHPs): An Epicenter of Healthcare Transformation?”

Apple’s recent announcement about its HealthKit platform is a beacon of a much bigger trend. We are at the early stages in the rise of a new business and IT ecosystem:

Patient Digital Health Platforms (PDHPs)

These new platforms should be high on the radar screens of healthcare providers. While v1.0 of PDHPs is starting fairly narrow, companies will be highly incentivized to move up the food chain into mainstream health data exchange, workflow integration, and virtual care delivery. PDHPs portend both opportunities and threats.

I’ll pose and provide some early answers to how the PDHP ecosystem might shape up. Here’s a preview:

  • What’s “The Healthcare Platform Void”?
  • Who Are Initial Players in the PDHP Ecosystem?
  • A Central Question: Will PDHPs Go Narrow or Broad?
  • What Market Pressures Incentivize PDHPs to Go Broad?
  • What Are Early Warning Signs that Some PDHPs Will Go Broad?
  • How Long Will It Take For All This to Play Out?

Consider this an introduction to PDHPs—you will discover more questions than answers. I’ll use Apple HealthKit as a case study to illustrate some examples.

Healthcare Transformation: Coping With the Neutral Zone

I’m being asked the same series of questions a lot lately:

Do you think the changes occurring in US healthcare are real?  Are we truly moving away from rewarding volume of care under fee-for-service (FFS) and toward value-based payment and delivery? Are the changes past the point of no return? Will the economic interests of the powers-that-be prevent real change from happening, just as they have done in the past?

The phrasing of these questions assumes a split, dichotomous view of the world — that change has/hasn’t yet happened. The questions also mask the underlying and difficult process of transition that people and organizations are going through.

There’s a different way to think about the transformation of U.S. healthcare — transition as a 3-stage process:

William Bridges 3 Stage Transition Model


Here’s a summary of where I’m going with today’s essay:

  • Think of Transition as a 3 Stage Process
  • U.S. Healthcare—Entering the Neutral Zone
  • How Long Will the Neutral Zone Last? Quite a While.
  • So What? What are Implications and Actions? 

Healthcare Social Media: Real Engagement or Fluff?

Reprinted courtesy of mcol

Today’s Topic

Would your personal experiences and observations of healthcare social media indicate that real engagement is generally occurring, or to-date Is it mostly just promotion and marketing “fluff” that is being facilitated – and how can healthcare engagement objectives be better met?

Cyndy Nayer

President, CyndyNayer.com
Founder, Center for Health Value Innovation

As a person who uses social media to advance healthcare ideas, projects and policies, I’m obviously intrigued and excited about social media mean to the connected health. The opportunity to learn and share globally is huge, but it can be debilitating because of the vastness. So the question of “fluff” is excellent: who and how one interacts and is reciprocated is paramount to the success of healthcare social media, otherwise known as #HCSM or, often, socmed or somed. For those who understand the intent of each venue, harnessing and engaging the crowds is powerful. For those who don’t, here’s a quick primer:

Twitter is the headline, Facebook is the abstract, LinkedIn is the targeted focus on business (which, while it may seem more targeted, is actually broadening in scope everyday), YouTube is the movie trailer for coming attractions, Pinterest is the commercial, blogging is the foundational “home” that launches all of these apps, and it grows from here.

Social media shares information with those who care to tune in. Most definitely it’s not “fluff,” unless posts of any kind turn to deep, self-revelatory items or soundbites with little backup. Folks must choose their “channels” carefully, and even within, choose their “follows” even more carefully. I find that follow many, and many follow me, but I choose focus and interaction as my own work evolves.

The promise of social media lies in the interaction of the healthcare and healthy lifestyle systems with the end user, the consumer. With EHRs changing and merging along with the mergers and acquisitions within the healthcare delivery system, socmed can get confusing, cumbersome, and, in my efforts, often is turned off to the very persons who need the engagement: the patients and their families. That throws the consumerism into the user’s choice rather than a shared decision, where it would be more valuable.

My Health Information Should PRECEDE Me, Not Just Follow Me

To state the obvious, there are times when the value of information depends on timing. Sometimes information needs to be provided in advance.

Consider a few examples. How valuable would the following types of information be to you?

  • From your GPS car navigation device: “You should have turned off at the last freeway exit”.
  • From the National Weather Service: “A class four tornado is hitting your neighborhood right now”.
  • From an airline when you arrive at the gate: “We canceled your flight five hours ago because we needed the plane on another route. Sorry”.

The Federal ONC (Office of the National Coordinator for Health IT) website speaks to the value of creating a secure, interoperable nationwide health information network:

A key premise is that information should follow the patient, and artificial obstacles — technical, bureaucratic, or business related — should not be a barrier to the seamless exchange of information. (Emphasis added)

Quiz: Is Healthcare Next on the List?

Pop quiz:

What do address books, video cameras, pagers, wristwatches, maps, books, travel games, flashlights, home telephones, cash registers, Walkmen, day timers, alarm clocks, answering machines, The Yellow Pages, wallets, keys, transistor radios, personal digital assistants, dashboard navigation systems, newspapers and magazines, directory assistance, travel and insurance agents, restaurant guides and pocket calculators all have in common?

This question was posed by Paul Nunes and Larry Downes in their recent Forbes article “How Innovations Become Better and Cheaper“.

For today’s quiz, we’ll have 3 levels of scoring– 2 points for a good answer, 5 points for a better answer, and 10 points for the best answer.

The 2 point answer: each of these products or services is in the process of being disrupted by a new technological innovation.

The 5 point answer: each of these products or services  is being supplanted  by what Nunes and Downes refer to as a “Big Bang Disruption”.  Read their Harvard Business Review article for more details on Big Bang Disruption.

The 10 point answer?

3 Critical Elements of Clinical Collaboration

A colleague recently wrote to me and asked me my definition of “collaboration”.

It doesn’t mean that care providers need to hug each other and sing Kumbaya. Ideally, care providers will like each other, but that’s not foundational.

I see 3 critical elements to clinical collaboration: