Neil Jennings – The Health Care Blog

Which Platform of Platforms (UDHP) is Right for your Health System? A Market Analysis

Aug 14, 2025

By NEIL JENNINGS & VINCE KURAITIS

This entry is part 5 of 5 in the series Platforming Healthcare — The Long View

In previous posts in this series, we have covered the definitions of Unified Digital Health platforms and whether “EHRs can become UDHPs.” In this follow-on post, we’ll talk through the requirements for success for a UDHP and which types of healthcare organizations are best suited for which types of UDHPs. This post will build on findings from the previous posts.

The Market Needs UDHPs: Key Takeaways from Previous Posts

Key Takeaway 1: The healthcare industry needs UDHPs to create a centralized, common architecture for healthcare organizations

Key Takeaway 2: The healthcare organizations leveraging UDHPs will achieve a myriad of benefits, from competitive advantages to clinical, financial, and operational gains

Key Takeaway 3: UDHPs are not all-or-nothing or mutually exclusive from EHRs. As we explored in our last post, EHRs could expand into UDHPs. These EHRs as UDHPs (or the relative platform of platforms) may be the optimal choice for some market segments. EHRs may also be accommodated into cloud-first UHDPs.

Key Takeaway 4 / Guiding Criterion: This post will focus on US regional and local health systems and outpatient groups of all sizes.

The Approach: Market -> Segments -> Options -> Fit

For this post, we will start from the top-down market perspective, analyzing the overall market landscape.
Once we have described the landscape, we will call out the key segments (organization types, sizes, and profiles) that we will be evaluating.
At this point, we will approximate IT budgets and IT team sizes by organization type to determine capabilities of building as opposed to depending on partners and vendors.
Then, we’ll review the constraints for implementation and ownership, outlining the drivers of UDHP fit.
Next, we’ll break down the different ways UDHPs can be developed and maintained.
- Leveraging an EHR as UDHP
- License from UDHP vendor
- “Home grown” cloud-first solution
Finally, we’ll crosswalk the segments and the optimal option for each segment, based on their specific needs and estimated IT and budgetary resources.

The Healthcare Market & Major Health System Segments

Starting with a compelling graphic from the Kaiser Family Foundation, we see a 2023 breakdown of the total US healthcare medical expenditure, totaling ~$4.9 trillion.

While the total healthcare spend that occurred in hospitals is an astounding ~$ 1.5 trillion, accounting for 31% of total healthcare spend, this leaves much of care outside the four walls of hospitals. This amount of care occurring outside of hospitals aligns with efforts to push patients into less acute care settings, emphasizing preventative, proactive medicine instead of acute, reactive medicine. As the need for UDHPs applies to more than inpatient hospitals, we will also review the other segments highlighted in the pie chart, including: outpatient clinics and practice groups, and “other health” containing services delivered at other contexts like PACs and SNFs, and Ambulatory surgical centers.

Can EHRs Expand to Become Health Systems’ “Platform of Platforms” (UDHPs)?

Jun 12, 2025

By VINCE KURAITIS & NEIL JENNINGS

In a previous post in this series, we discussed healthcare’s migration toward Unified Digital Health Platforms (UDHPs) — a “platform of platforms.” Think of a UDHP as healthcare’s version of a Swiss Army knife: flexible, multi-functional, and (ideally) much better integrated than the drawer full of barely-used apps most health systems currently rely on. We included a list of 20+ companies jockeying for UDHP dominance, including two familiar EHR (electronic health record) giants — Epic and Oracle. This raises the obvious question for today’s post:

Can EHRs level up into becoming UDHPs — becoming healthcare’s platform of platforms? Or are they trying to wear a superhero cape while tripping over their own cables?

We see good arguments pro and con, and like most things in healthcare “it’s complicated.” Some say EHRs are uniquely positioned to make the leap. Others believe the idea is like trying to teach your fax machine to run population health analytics.

Thus, we’ll lay out the arguments for differing points of view, and you can decide for yourself.

This entry is part 4 of 4 in the series Platforming Healthcare — The Long View

by Vince Kuraitis and Neil P. Jennings of Untangle Health

Here’s an outline of today’s blog post:

A Brief Recap: What are UDHPs?
Thesis: EHRs Can Expand to Become UDHPs
1. EHRs Currently Own the Customer Relationship
2. Many Customers Have an “EHR-First” Preference for New Applications
3. Epic and Oracle Health are Making Strong Movements Toward Becoming UDHPs
Antithesis: EHRs Can NOT Become Effective EHRs
1. EHRs Carry a Lot of Baggage
2. Customers are Skeptical
3. EHR Analytics Are NOT Optimized To Achieve Critical Health System Objectives
4. EHR Switching Costs are Diminishing
5. Cloud Native Platforms Accelerate Innovation and Performance
6. It’s Not in EHR DNA to Become A Broad-Based Platform
Synthesis and Conclusion

This is a long post…over 4,000 words…so we’ve clearly got a lot to say on the matter. Hope you brought snacks!

A Brief Recap: What are UDHPs? (Unified Digital Health Platforms)

In our previous extensive post on UDHPs, we described them as a new category of enterprise software. A December 2022 Gartner Market Guide report characterized the long-term potential:

The [U]DHP shift will emerge as the most cost-effective and technically efficient way to scale new digital capabilities within and across health ecosystems and will, over time, replace the dominant era of the monolithic electronic health record (EHR).

The DHP Reference Architecture is illustrated in a blog post by Better. Note that UDHPs are visually depicted as “sitting on top” of EHRs and other siloed sources of health data:

We noted that almost any type of large healthcare organization — health systems, health plans, pharma companies, medical device companies, etc. — had a need for UDHPs. However, today’s focus is more narrow — we limit the discussion to UDHPs in hospitals and health systems, primarily in the U.S. We use the term “health system” to encompass hospitals and regional health delivery systems.

In this post, we focus on the two largest EHR vendors in the U.S. — Epic and Oracle Health; they have a combined market share of 65% of hospitals and 77% of hospital beds.

In the remaining sections, we will lay out arguments on both sides of the issue of whether EHRs can (or cannot) expand to become UDHPs. The graphic below is our crack at a visual summary. The balloons represent the thesis – that EHRs can expand to become UDHPs; the anchors represent the antithesis – that EHRs can not expand to become UDHPs.