The coming of a platform revolution

The healthcare delivery systems of today will increasingly leverage the platform and the resources that they have in place to become a hub for both health and healthcare in the future By Raelene Kambli

In November 2018, Forbes published their annual study on the world’s most valuable brands. Coming as no surprise, Apple topped the list of branding behemoth for the eighth time, gathering an eye-watering brand value of $182.8 billion—up by 8 per cent from the previous year—followed by Google at $132.1 billion, Microsoft at $104.9 billion, Facebook at $94.8 billion and Amazon at $70.9 billion.

So what’s the trump card that allows these tech giants to have such an authoritative presence in the mind of the modern consumer?

Is it because of the perceived value, the high quality products, the fantastic services and more that these companies offer?

Yes, all these factors contribute to their riding success but there is certainly something more to it.

It is called the Platform
Take Apple for example. Apple’s platform has been one of the biggest factor fueling a faster rate of revenue growth for the company than all of its hardware segments combined. Its platform connects the iOS ecosystem to various devices and aims to create the best platform experience for its customers. So each new Apple product you buy improves the experience on all the other Apple products you already own – particularly the iPhone.

For instance, both the iPad and the MacBook get even better connected if you already have an iPhone, since the iOS platform connects these three devices and you get the ability to sync texts and send photos across the devices.

Likewise, companies such as Google, Amazon and Facebook too leverage the new tech paradigm and earn ginormous value through their respective platforms. These tech companies use their platforms to not only dominate the market share for their businesses, but their platforms also gives a new competitive advantage- a strong reason to build perceived value and boost the immense brand loyalty that drives their success stories.

Today, buoyed by the success of Apple, Amazon, Google and Facebook, thousands of companies of all sizes across industries and around the globe are rethinking their business models. Leveraging the tech paradigms, they are creating vibrant ecosystems and, in the process, reap big rewards.

Now, one might wonder what has these tech giant’s platform business models got to do with healthcare companies?

Well, the answer lies in the need for healthcare companies to build brands that can create such perceived value, win patient trust and earn long lasting brand value using digital platforms. Wondering why? We spoke to some healthcare technology and business experts who tell us how companies, especially hospitals, can take advantage of the platform and resources that they have to become a hub for both health and healthcare in the future.

Moving from product strategy to platform strategy
Today, the Indian healthcare sector is at the cusp of a digital revolution. Technology has already touched every aspect of healthcare delivery, therefore, experts feel the need for healthcare organisations to move from being just a healthcare provider to creating a platform for health and healthcare in their community.

On the global front, healthcare companies are already moving from a traditional concept of buying, building hospitals and simply providing care to newer dynamic strategies that focus on leveraging the platform they have in place to create more value and growth via more profitable streams of revenue.For instance, Mayo Clinic is already operating as a platform today. Their platform includes leveraging research, big data, expert clinic insights and artificial intelligence to create new value for Mayo’s clinical practice as well as new opportunities for Mayo’s partners.

Seeing that the platform can be a great business enabler in healthcare, Amazon teamed up with Berkshire Hathaway and JP Morgan and Chase to build its own healthcare entity. In addition to the venture, Amazon also has designs on companies already in the space. It acquired an online pharmacy Pill Pack for just under $1 billion, according to US new reports. Then, Amazon announced a slew of HIPAA-eligible services, including a machine learning tool for healthcare developers. These moves clearly indicate that Amazon won’t leave an opportunity untapped.

Experts feel that from a company’s profitability outlook, there seems to be an enormous upside to those companies who understand this pivot and take advantage of such market changes. This is one reason why Indian healthcare companies, especially hospitals, need to think beyond a product or service strategy of business to a platform strategy.

Given that the healthcare sector in India is said to be one of the largest employers in the country, there are immense opportunities for companies in this space to become a hub. As per experts, healthcare providers in the past have leveraged that position to simply care for the sick. They are expected to become healthcare hubs for innovation and build new companies to bring the community together. These companies will then tackle large public health issues, strengthen education and training, encourage research and development partnerships, build support groups for specific chronic conditions, create communities for digital and virtual care, and for thoughtful and effective support for mental and behavioural health.

Opines Joy Chakraborty, COO, P D Hinduja Hospital, “The healthcare ecosystem in India is already a milieu of intertwining facets of technology along with physical and biological aspects of patients, providers and caregivers relying on networks and technologies to carry out and sustain various activities. Therefore, a platform solution is just the next level in this integrated healthcare world wherein the service or healthcare provider can provide comprehensive services on a new interface.”

Similarly, Sumit Puri, CIO, Max Healthcare, says, “It’s a great strategy and will help the service provider from moving up the value chain and creating a holistic and comprehensive solution for
its customers. However, core strengths and current capabilities of the service provider need to be assessed carefully before moving in this direction. A realistic assessment should entail understanding whether the service provider has the ability to constantly innovate and create newer sources of value for its customers through its healthcare platform. Nevertheless, the benefits are clearly higher stickability and customer retention by providing enhanced customer value which would translate into higher business revenue and growth.”

Explaining the difference between this new approach and traditional business models,Girish Kulkarni or GK as he is know with his colleagues – peers – friends, The Principal Consultant – IT, AICPL TM & SVP Hospital, describes, “Product by its mere core competency is all set to solve a set of problems for the intended user, by its unique design and delivery of its features where as a platform can be visualised to leverage multiple set of such-similar products in the eco-system to aggregate the ability across multiple products and solution sets. Platform what we talk about is set to leverage the existing product lines within its eco-space as well as across such similar products in an enterprise environment. Now to talk about its relevance in healthcare, especially in provider space / hospitals, there is a strong mix of unique products and its services being offered by multiple products and more so from multiple vendors. If platform can be envisaged in this context to leverage each of its product capability without duplication of omponents/design etc, there comes the slogan ‘Economy of Scale”.

“Healthcare platform can also be considered as a business framework. By this I mean a framework that allows multiple business models to be built and supported. Examples of HMIS-Patient centric application and its extended design on Patient Portal, Mobile app as one side of a triangle, where as organisation wide ERP applications such as SAP / Oracle etc towards asset / resource specific ERP’s. Thirdly in the context of connected world, there would be third party – online applications / vendors on a different business models for its optimised use (Such as Travel, Hospitality related applications). When you design a platform for your organisation , if we can identify the common objective / design components across which one can utilise common API’s as an example), there could be huge transformational shift for value optimisation as an organisation”, he asserts.

What’s happening in India
While experts endorse for a platform model, there are some healthcare companies which have already set on this path to create such platforms. Companies such as Cure.fit, Portea, Lybrate, Practo, LiveHealth, Murgency, Forus Health, Onco.com and more are taking several strikes in this direction. Equivalently, some hospital chains and technology companies are also working in this direction.

Chakraborty updates on how the Indian healthcare ecosystem experiencing this momentum. “Currently the healthcare scene has a few established platform systems- Philips HealthSuite, Amazon’s Alexa and Siemens Healthineers digital ecosystem. Several Doctor Patient Platforms have also risen in India which includes Practo, Lybrate, JustDoc, etc. Philips HealthSuite for example is a digital platform for connected healthcare for patients and providers, in any setting, hospital and home. It’s an open, cloud-based platform that collects, compiles and analysis data from a range of devices and sources, and technology brands. It helps bridge care from the hospital to the home and integrates the various care teams. The approach of the above platform solutions is to offer actionable, data-driven insights which enable patients to work together with their care providers including family members. Once integrated, this data and predictive algorithms can find correlations and subtle signs, like health deterioration of the patient can be caught at an early stage. The healthcare business by its inherent properties needs to work in a network, and a platform will provide this streamlined solution. Both the sides are engaged due to a number of benefits created by a platform ecosystem. A customised platform like the ‘patient engagement’ platform mentioned above will create value for our hospitals in several ways. Engaged patients are happy patients, and are therefore long term patients. From the patient’s perspective, they will get a menu of offerings and options which they can study, understand and then select —making them participate in their own healthcare choices. Interactions with different participants will provide support to the patients not only from family and friends but in form of support groups for social and psychological support.Integrated data will help not only patients but even healthcare providers identify the patients’ needs early on and plan a precisecourse of treatment. A successful implementation of this business model will in turn boost referrals for services to the hospital and in turn revenue”, Joy elaborates.

Similarly, Puri explains how Max Hospital has created a platform and how it functions. “We have already created a self service patient portal where we have several sources of value for our customers and the focus is on continuing to enhance the services offered. Our current services including a digital health locker for patients, which would contain digitised diagnostic and medical reports, e-Prescriptions, discharge summaries etc besides enabling, booking of doctor appointments, Max@Home or in-hospital services including PHP and radiology etc., getting online discounts and waiver of initial registration charges, consolidated linkage of family members’ records, calling emergency services including ambulance etc. What we are hoping to do is offer more personalised content on the patient portal considering his / her individual condition, provide customised care pathways and ease of adherence to patients for vaccinations and lifestyle related diseases to manage a healthier lifestyle outside hospitals”, he spells out.

Puri strongly believes that their platform model will deepen their engagement and understanding of customer needs. “We will hopefully, in the future, be offering personalised applications and treatment plans on both web and mobile for various categories of customers both at home and in the hospital so that we can offer a one stop shop for all patients’ healthcare needs. Also, we have already integrated complaints and feedback functionality in the portal and our patient mobile app, so that we can carry out any redressal of genuine patient grievances even before the patient has left the hospital”, he quickly adds.

So does this new strategic concept of being a platform requires new thinking, new structures and new skill sets? What kind of investment would it demand? And what kind of returns it would fetch?

What it means to be a hub
Platform models work on a collaborative model, which means companies may even need to collaborate with competitors in order to build strong networks. Therefore, a change in the organisation’s thought process becomes paramount. Says Puri, “Platform approach requires very high level of customer centric approach and a lot more collaborative mindset where you might also need to sometimes collaborate with your potential competitors. It would require various technological and operational aspects of the organisation to come together structurally so that siloed department level thinking can be replaced with an integrated enterprise wide customer centric approach where people, processes and power of technology can be married seamlessly. Also, skill sets of data scientists with knowledge of Artificial Intelligence and Machine Learning, and business domain analysts with sound business understanding would be needed in order to gather and glean actionable insights from the structured and unstructured data available in healthcare institutions. The investments needed would be significant but returns would be multiple times the investments made by the organisation, if implemented effectively”.

“The platform business model will have to be one of the core components of corporate strategy planning. This network strategy will have to be aligned with the right choice of platform-enabling technologies, like cloud technologies, big data solutions, modular architecture, IoT, and AI solutions. All of these will require a substantial investment and will also need expertise in terms of manpower to power and implement a successful healthcare platform. However the expected returns will be substantial in terms of both tangible and intangible benefits”, chips in Chakraborty.

Adding to this, Niranjan Ramakrishnan, CHCIO Vice President Digital, Leixir, says, “Overall success of the healthcare platform is to be measured by the value of investment not by the return on the investment. Hence the investment needs to be based on the value that the business is trying to get from the platform, which is not only the topline, EBITDA but customer experience, efficiency, turnaround time and productivity as well. Understand the difference between upfront investment over the total cost of ownership and it has to be at least for the period of five calendar years. Also, building a culture of Information Technology within the environment which is totally different from how healthcare institutions function today.”

Having said this, there is a level of urgency to move quickly. We have started to see a slow-down in business models already. If hospitals don’t expand the role they play in both health and healthcare in their community, someone else will step in.

So, how are IT experts in this space planning this transition?

The action plan
In future, Indian healthcare will witness a significant transformations in business models and digital technologies will play a pivotal role in this metamorphosis. Hence, It expert in this field suggest that orgnaisations, especially hospitals, need to have a serious forethought and strong master plan for building a platform.

“There should be a lot more focus on outside in customer thinking and customer journey workshops in order to derive key pain areas of customers so that the same can be effectively addressed. The change management, training and user socialisation issues need to be understood and key strategies planned to align all aspects of the organisation, including the doctors, customer facing employees and nurses in order to elicit active participate in the action plan so that ownership and user adoption can be significantly enhanced,” suggests Puri.

Sharing his perspective on how the platform can be optimised in a hospItal setting GK delineates, “The Hospital platform element is the exposure of its customer facing components / social graph to external applications which enable a different set of use cases. Customer centric focus to consider now: For e.g, HMIS product on a hospital digital platform can interact with citizen centric patient portal for a seamless interaction between care-providers across hospitals and patients across locations through a single platform. Likewise if you can think from an operational efficacy standpoint, typical ERP analytics alone can’t optimise the connected streams with patients, here HMIS which is patient centric can bring out patient specific trends and outcome, through its platform to optimise/maximise the value proposition , both for operations staff within hospitals as well as with connected external vendors outside the hospitals. Another example here is patient App on mobile: a platform could be your smartphone i.e. it has its own device form factor and its own ability to interconnect with other software streams, therefore it’s a platform that you can do other things with that were not originally envisaged at the time of its initial design.”

Niranjan further lists down some action points which can be considered by hospitals:

• Start with the preparation of a detailed business case and get it validated with industry experts
• Focus on systematic due diligence on the requirements of healthcare industry as a business organisation, various stakeholders such as hospital administrator, patients, doctors and allied health professionals and business potential.
• Ensure the documentation of all the assumptions, identified risks and anticipated challenges well in advance.
• Put together a time bound evaluation process and limit the exercise to specific number of iterations.

Going forward, experts envision the coming of the platform revolution in healthcare. Picking inferences from the experts, healthcare organisations/ hospitals need to create the digital front door well in time. They will also need to ensure that their platfroms drive affordability and reduce cost, tackle social determinants of health and healthcare delivery and create partnerships for healthcare innovation. In order to enable the effectiveness of the platform in healthcare, organisations will need to also focus on the lifeline for every health and healthcare hub-actionable data. Consequently, leveraging applied analytics will become crucial.

[email protected]