Why Digital Ecosystems Are Needed in Healthcare

As the focus of healthcare has largely shifted from fighting acute, infectious diseases to managing and preventing chronic illness, the nature of healthcare has needed to change. Healthcare in many regards lags behind other industries, in part due to strict regulations regarding customer data privacy as well as approval of new technologies. The healthcare industry is set to be transformed by companies willing and able to develop ecosystems, which would improve the patient experience as well as reduce overall costs. The status quo, most especially within the USA, of inadequate care at unaffordable prices and with great inefficiency makes the healthcare industry ripe for disruption.

Ecosystems tend to arise when they:

• Benefit from network externalities.
• Leverage data generated within the ecosystem to provide personalized solutions.
• Reduce industry inefficiencies.
• Increase barriers to exit.

One particularly famous example of an ecosystem in another industry would be Apple, which has created a walled garden of sorts. Each additional device or service serves both as an additional revenue stream for Apple as well as another incentive for customers to remain loyal to the brand. Through this, they can also capture more value along the supply chain, for example, charging apps in the app stores 30% of their revenue. In order for an ecosystem to be successful, it needs to produce more value as whole than each part separately. 

Ecosystems in healthcare, just as elsewhere in other industries, will be centered around the customer. A successful model could process data from a variety of sources through advanced analytics to ensure the health of the customer and provide better care. Some applications of this could be, for example, an integration of data from apps or devices that track daily activity or diet. As the wearable devices continue to evolve, this could also include more serious data such as oxygen levels, heart rate, blood sugar levels, etc. These could be used to both provide better care and provide better analysis for insurers. The goal of these integrated healthcare systems will be improving outcomes for patients. 

For chronically ill patients, it would be of great benefit to create an ecosystem where there is an end-to-end integration between service providers and their sources of financing. Moreover, integrating technology into the equation could ensure that patients are receiving the care they need and could send an alert directly to the care provider, should a patient fall or some other event be detected. For an elderly retiree, this ecosystem could utilize her full data – financial, health, social, etc. – to provide her with a variety of services according to her needs, such as prescription and weekly meal deliveries. Advanced analytics could detect when a proactive phone call is necessary. Insurance and payment information could be integrated so that payments would be seamless.

However, there are challenges in creating a digital ecosystem within the healthcare industry. One of the largest is data liquidity. Data is foundational for the value-capturing insights in ecosystems. It is through data that a more personalized and valuable customer experience can be provided. But in both Europe and elsewhere, patient data rights are heavily protected. A lack of standardization of data sets also impedes data sharing. However, there are examples of reform in other industries, such as the introduction of SWIFT in finance, where data liquidity was improved through regulatory reform and data standardization.

The next challenge once data liquidity issues have been settled will be developing the intelligence to extract the full value out of the data. This will require advanced analytics, artificial intelligence, and machine learning. Through advanced, predictive analytics, patient risks will be identified and mitigated. Developing the intelligence will require a significant investment in software development, which is not particularly the forte of incumbent health firms. This leaves an opening for digital natives to disrupt the market, which one can observe in the market already with Google's and Amazon's healthcare initiatives. 

Incumbent firms still have a large role to play in the development of their ecosystems' IT architecture. Those who act first and develop their ecosystem will have a first-mover advantage and be able to negotiate from a stronger position when creating partnerships, which will likely be a necessary aspect of any successful ecosystem. Software development, which is inherently complex and intransparent, can pose an overwhelming challenge even for more IT-affine companies. This is why many corporations in diverse industries have invested in software process mining technology, which provides a data-driven foundation for creating and managing corporate IT strategy. 

Beyond just developing the infrastructure for collecting, processing, and analyzing vast amounts of data from various sources, healthcare ecosystems will also require a digital platform for engaging customers. Leveraging the insights gained from the predictive analytics, digital platforms will offer customers a curated set of services, which could include everything from daily health monitoring to appointment scheduling and transportation. This will also necessitate leveraging all the capture data from healthcare-related activities.

Looking Forward

The fate of incumbent healthcare companies still lies in their own hands. Their strategies for the future must be determined – will they prefer to curate their own ecosystems or rather play the part of a partner? Shall they develop most of the necessary IT infrastructure themselves or purchase it out of house? Companies that wait too long to determine their strategy and, more specifically, their software strategy risk disruption by the entry of tech giants into the market.