Innovation Pulse: Can platforms foster an ecosystem of IT advancement?
Editor's note: This is the inaugural installment of "Innovation Pulse," a new Healthcare IT News column focused on health technology advancement by HIMSS Media Executive Editor Tom Sullivan.
Meet the new linguistic mashup: "plecosystem," meaning a technological ecosystem comprising different platforms.
I first heard the phrase spoken by John Mattison, MD, Kaiser Permanente's chief medical information officer. Platforms are coming from technology leaders such as Apple, IBM, Google and Microsoft.
"The best prospect from one of these players is that it's a platform," said Steve Savas, managing director of clinical services at Accenture. Rather than trying to create apps that target specific conditions or diseases, the tech stalwarts are building platforms on top of which independent developers can build those very targeted apps. "And that's the place they could have the biggest impact."
IBM and Apple, for instance, have been forthright in saying that "the art of the possible" figures prominently into their plans to foster an ecosystem of applications on top of HealthKit, the iOS and Apple hardware platform. And they do stand to profit handsomely if independent software developers give hospital chief information officers reason to buy armadas of iPads.
"I think the innovators would welcome it from Apple, Microsoft or others because then there are standards and the uptake costs for adopting new innovative technology drops precipitously and it can create an ecosystem around it, much like the app ecosystem around the iPhone," Savas said.
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Such a plecosystem, of course, presumes that these new platforms go the way of the iPhone and iPad – stimulating waves of original applications – and don't follow the iPod, which devoured the MP3 market and effectively squashed innovation in that realm.
We're already seeing evidence of the potential for this new plecosystem in mobile health. Provider-centric apps geared for Apple's HealthKit have emerged, ranging from American Well's AmWell, which enables live video visits with doctors, to Patient IO, an app with which physicians can send specific treatment reminders directly to patients.
While the Mayo Clinic has aligned with Apple and Epic in a high-profile triptych, other leading providers are also innovating on Apple's platform. The Cleveland Clinic, for example, has a quiver of apps that run on top of both iOS and Android to target specific conditions including cancer, epilepsy, heart disease, sleeping problems and general wellness.
Electronic health record makers are hopping on board, too. In addition to Epic, athenahealth and Cerner revealed plans to integrate with Apple's platform almost immediately after HealthKit launched; over the summer Apple was also rumored to be in talks with Allscripts.
What's more, with industry analyst firms such as Black Book projecting that the provider landscape will see widespread switching to new EHR vendors, more and more EHR makers are going to tune their software for tablets, phablets and smartphones.
Let's just speculate, for instance, that Apple manages to arrange things such that iPads and iPhones, pre-loaded with mobile-optimized software from Allscripts, Epic or a small and controlled choice of EHRs, are sold and supported by IBM. Well, that's a pretty compelling product.
Likewise, Microsoft and Dell could roll together something similar on the Windows platform. Same goes for Google's Android. Apple products, despite their cool factor, are not for everyone, after all.
Regardless of platform – Android, iOS or Windows – as those configurations become available are you really going to buy your next EHR any other way? And what are your patients going to demand, moving forward, when it comes to consumer-facing products?
We're about to find out. For instance, enough people asked for new means of connectivity and more touch points with doctors that Ochsner Health System integrated its Epic EHR within weeks of HealthKit's release, according to Richard Milani, MD, Ochsner's chief clinical transformation officer.
Much like Ochsner, Duke Medicine integrated Epic with HealthKit right away because it has been trying to better understand how patients are doing on a day-to-day basis at home rather than just during the rare office visits when doctors see them.
"Technologies like HealthKit open the door to patients choosing to share data," said Ricky Bloomfield, MD, director of Duke's mobile technology strategy. "That will let doctors make more informed treatment decisions in cooperation with them."
That last point is where the platform surpasses any single digital nanny or wellness app feeding a wearer's health data into the black hole so many proprietary vendor databases truly are.
Indeed, the overarching plecosystem theme here is the integration of those apps and devices within EHRs and clinical decision support tools, as Mattison told me when I met him at the Healthcare IT News Big Data and Healthcare Analytics Forum in Boston this past November.
That will enable "doctors to lead more with empathy, and to understand values and outcomes to deliver what patients want, not what we think is best for them," he said.
Right now, the plecosystem momentum is powerful – even though Apple, IBM, Google and Microsoft are just getting started – and there's every reason to believe it will get stronger in the months ahead.
"The platform approach," said Accenture's Savas, "will proliferate the innovators."