What is a 'platform' anyway?
This is the question 18 healthcare executives set out to answer during a roundtable session supported by athenahealth at the Becker's Hospital Review 10th Annual Meeting in Chicago on April 2.
"I would argue that there are a lot of factors that go into the answer to this question, but at a minimum it boils down to something really fundamental: Platforms bring scale and speed to the matching of resources to their highest and best uses," said Jessica Sweeney-Platt, executive director at athenahealth.
To bring this definition to life, Ms. Sweeney-Platt pointed to two brands in the hospitality industry: Airbnb and Hilton. Although they represent different models, both companies are fundamentally in the business of selling rooms. So which is a platform? Airbnb, because the company brought speed and scale to an area with considerable amount of underused assets.
Here's how.
The traditional hotel business model is expensive and capital intensive. Hilton, founded in 1919, is one of the largest hotel chains in the world with 769,000 rooms in 78 different countries. A major hotel operation needs millions if not billions of dollars to build its resources, and it took many many years for them to amass this inventory. And their business model is to then charge room rates to recoup those expenses.
Enter Airbnb. The 10-year-old company turned this hospitality model on its head by identifying an untapped network of underused resources — people's apartments and vacant guest rooms. In roughly six years, Airbnb build an empire of 2.3 million rooms in 191 countries. It brought speed and scale to a well established industry , and it used technology to connect all those disparate nodes.
So what's the connection to healthcare? That's the billion-dollar question.
Dreaming up healthcare platforms
"We've got a lot of attributes in the healthcare delivery business that make it ripe for this kind of transformation," Ms. Sweeney-Platt said. "We've got tons of capacity. I'm thinking of both physical infrastructure, like buildings and clinics, but also human capacity. Healthcare has people and talent who are underutilized. And a lot of that capacity is locked up in silos, and the process for moving those assets to their highest and best use is often painfully slow, manual and imprecise."
Platforms find underused or undervalued assets, then connect them to generate greater value for those who tap into that network, whether those users are buyer, sellers or a combination of the two. This has played out in hospitality with Airbnb, in transportation with Uber and in retail with Amazon.
What does it mean to be an acutal / real platform in healthcare? Ms. Sweeney-Platt asked leaders to conceptualize. While healthcare may not have vivid examples of platforms to point to right now, healthcare leaders in the room described what game-changing platforms might do.
"I would like to see a platform that brings about democratization, meaning the end user can do things that were previously slowed down because you previously had to do them within the system," said the CMO of the hospital division of a diversified post-acute healthcare provider. "If you can schedule your labs, make your doctor's appointment and access results on your phone, you would skip three people and maybe do this in four clicks rather than four days. It's the same way you don't need a desk person to book your room." This conceptual platform would reduce cost, personalize the care experience and make it more time efficient.
"I imagine the healthcare platform to be agile and customer-centric. It would remove barriers for patients and be just as easy for them to use as Google or Amazon," said the vice president for quality and safety at a 1,426-bed system in the Southwest. This imagined solution would reduce the levels of friction users experience in the system by masking the complexity of the work that goes on behind the scenes.
"I'd like a platform that would be able to provide people's medical records to all providers across the continuum and across all different EHRs," said the vice president of population health and quality for a 234-bed hospital in the Midwest.
Another executive described a desirable platform as one that specializes in information integrity, where users can actually rely on what they read and have it presented to them, summarized in a format they can use quickly. Copy and pasting, contradictory information and inaccurate information — it all makes the life of the clinician very hard, and it takes up a lot of time.
Building the healthcare platform
From the discussion, it was clear that there is no standard industry definition for a platform in healthcare. Bringing the idea of platforms back to ground-level, Ms. Sweeney-Platt said proposed a definition of platform for greater discussion.
"I want to differentiate what we mean when we say platform, because I think a lot of organizations calling themselves platforms today are offering what I would consider a comprehensive suite of services, but those services don't necessarily sit on or comprise a platform fueled by user interactions."
Healthcare platforms require two fundamental things. One: The platform needs an underlying environment that facilitates an entire network of user interactions. This is the bedrock necessary to build any type of platform. Two: The platform needs technical building blocks, which come to create the "app" ecosystem that consumers are most familiar with. These technical building blocks are the services and tools that are built upon the bedrock of the platform with the end user experience in mind.
When these two foundational elements are met and accounted for, only then is it possible for platforms to create tailored, customized solutions and enable information to flow in and out in a useful, usable way.
Platforms in play
Although healthcare may not yet have its own version of Uber, Airbnb or Amazon, platforms are nonetheless on the rise in the industry and several organizations are partnering with athenahealth.
Ms. Sweeney-Platt shared the stories of the following three organizations, which are essentially building their own bespoke solutions on the athenahealth platform based on what they need for their competitive environment and their patients, providers and stakeholders.
OurHealth — This Cambridge, Mass.-based company partners with employers to offer on-site and near-site primary care clinics. To support their business model, OurHealth needed to seamlessly exchange data across several different IT systems. The company partnered with athenahealth for its open platform and marketplace partners to create a solution tailored to its unique needs.
To support its high engagement model, OurHealth staff needed three solutions for a complete view of their patients. The customer service staff uses Salesforce to track member engagement via the traditional customer relationship management solution. The providers use an EHR to document clinic visits. Patients use a proprietary portal to access the information that is most useful and relevant.
OurHealth's previous EHR couldn't exchange data with either Salesforce or the proprietary portal. When OurHealth joined the athenahealth network, it was then able to integrate all of these disparate systems, which reduced inefficiencies and expanded capabilities.
Large US health system — This health system, used a platform to build a bridge between clinicians in its inpatient and outpatient care settings.
The health system worked with athenahealth to transition its ambulatory medical groups onto an athenahealth EHR product while keeping inpatient services on a non-athenahealth EHR and building connectivity between the two. The system also leveraged the athenahealth platform to streamline the referral processes for providers in supportof the system's business goals.
Privia — This Arlington, Va.-based national physician organization includes approximately 2,000 physicians with a presence in the Central, Southeastern and Northeastern U.S.
Privia uses the athenahealth platform to standardize performance across a large, dispersed organization. Its primary interest is ensuring all partner organizations and practices can access these standardized sets of business and clinical processes.
For example, one of the first tools Privia rolled out on its platform is a standardized process to help patients find a physician. Privia wanted a solution that reduced friction for patients and compiled the availability of all Privia providers together in one space. The online, direct scheduling functionality saves time for both patients and providers.
Takeaways
- Platforms bring scale and speed to the matching of resources to their highest and best uses.
- To be considered a Healthcare platform, there are two fundamental elements: an underlying environment that facilitates an entire network of user interactions and technical building blocks that are built with the end user experience in mind.
- Health system and hospital executives are eager for platforms that democratize healthcare; remove friction and are consumer-centric, like experiences found on Amazon and Google; uphold information integrity and present data in a usable, centralized way; and enable information-sharing across the continuum of care regardless of EHR vendor.
- Three health care entities are leveraging and building on the athenahealth platform for distinct purposes — patient engagement, provider communication across the inpatient and outpatient settings, and performance standardization.