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.
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
- EHRs Currently Own the Customer Relationship
- Many Customers Have an “EHR-First” Preference for New Applications
- Epic and Oracle Health are Making Strong Movements Toward Becoming UDHPs
- Antithesis: EHRs Can NOT Become Effective EHRs
- EHRs Carry a Lot of Baggage
- Customers are Skeptical
- EHR Analytics Are NOT Optimized To Achieve Critical Health System Objectives
- EHR Switching Costs are Diminishing
- Cloud Native Platforms Accelerate Innovation and Performance
- 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.
Thesis: EHRs Can Expand To Becoming UDHPs
Let’s look at the case for EHRs expanding to become effective UDHPs.
