1. "Platforms" for Accountable Care – A "Must Have", Not Just a "Nice to Have" Vince Kuraitis JD, MBA Better Health Technologies, LLC http://e-CareManagement.comhttp://e-CareManagement.com blog (208) 395-1197

2. 2 Gang of Four

3. 3 A Decade of Opening Up Platforms to 3 rd Party App Developers

4. 4 What’s a Platform? In any platform system, there are three types of components: (1) the complements, which exhibit high variety and high rates of change over time; (2) the core components, which remain stable as the complements change; and (3) the interfaces, which are the design rules that allow the core and the complements to operate as one system. Both the core components and the interfaces are relatively long-lived, hence part of “the platform.” Source: http://hbswk.hbs.edu/item/6025.htmlhttp://hbswk.hbs.edu/item/6025.html

5. 5 Platforms Get Enormous Value From 3 rd Party Developers Adapted from: http://www.smartgridnews.com/artman/publish/News_Commentary/The-Smart-Grid-Ecosystem- What-a-Platform-Approach-Could-Mean-to-Innovation-Security-and-More-1199.html

6. 6 Electronic Medical Record (EMR) Functionality 1 /Value Pre-2009 Order Entry Management Results Management Clinical Decision Support Health Information & Data EMR “Products” Value Quantity 1. EMR functions adapted from DesRoches,C. et. al., C. "Electronic Health Records in Ambulatory Care -- A National Survey of Physicians" NEJM; July 3, 2008

7. 7 Electronic Health Record (EHR) Functionality 2 /Value 2010-2015 Order Entry Management Results Management Clinical Decision Support Health Information & Data EHR Products/Platforms Value Quantity MU Stage 1 New Functionality MU Stage 2 New FunctionalityMU Stage 3 New Functionality 2. For an explanation and description of Stages 1-3 Meaningful Use (MU) criteria, see https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp#BOOKMARK6

8. 8 Scenario 1: Health IT Platforms 3 of the Future Order Entry Management Results Management Clinical Decision Support Health Information & Data Health IT Platforms (EHR or other?) Value Quantity MU Stage 1 New Functionality MU Stage 2 New FunctionalityMU Stage 3 New Functionality Patient Connectivity Quality Improvement Communication Public Health Reporting Research Advanced Decision Suprt Telehealth Mobile Apps Med Device Connectivity Hundreds of Future Apps 3. Health IT platform functions adapted from Mandl, K. and Kohane, I. "No Small Change for the Information Economy" NEJM; March 26, 2009

9. 9 Scenario 2: Health IT Platforms 3 of the Future Order Entry Management Results Management Clinical Decision Support Health Information & Data Health IT Platforms (EHR or other?) Value Quantity MU Stage 1 New Functionality MU Stage 2 New FunctionalityMU Stage 3 New Functionality Patient Connectivity Quality Improvement Communication Public Health Reporting Research Advanced Decision Suprt Telehealth Mobile Apps Med Device Connectivity Hundreds of Future Apps 3. Health IT platform functions adapted from Mandl, K. and Kohane, I. "No Small Change for the Information Economy" NEJM; March 26, 2009

10. 10 Platforms in Health Care: A “Nice to Have” or a “Must Have”? Under what conditions could you believe that health IT “products” are sustainable? –That one company can develop all needed functionality (apps), and –That Health IT will become a winner-take-all market Single payer, or One vendor’s product adopted by (practically) all providers in a regional market Not likely. Interoperable platforms are a “must have”.

11. 11 Implications? Care providers: recognize inevitable migration beyond an Enterprise EMR Health plans: –Evolving business strategies dependent upon availability of clinical data and analytics –Achievable without platform architecture? Investors: anticipate inevitable disruption of current HIT architecture; issue is when, not whether

12. 12 Explore the evolution of platform architecture, business ecosystems, and clinical care delivery Attend in-person or via webinar: http://himssconference.org/ecollaboration/default.aspx