Digital health’s platform wars are heating up

Back in August we predicted the starter pistol of the digital health platform wars, a concept we’ve expanded on in our recent perspective on the future of healthcare. This latest post in the series looks at some of the emerging platform types and explores what makes for a successful digital health platform.

What types of platforms are out there? There are already many—and they are continually evolving, with new ones emerging. We expect that state of flux to last for the next few years. Here are a few of the platform plays we’ve been keeping an eye on, and how they differ:

• Care Management platforms go deep in a specific condition(s), such as Omada, Virta and Maven.
• Convenience care platforms provide one-stop access to treatment and medication for a range of common conditions such as Ro, Cove, and Lemonaid.
• Unified virtual care platforms pull together primary care telemedicine with condition management, such as Teladoc-Livongo.
• Omnichannel retail health platforms such as Best Buy, CVS, and Walgreens leverage their retail expertise to provide a set of primary care, diagnostics, testing, and remote monitoring services.
• Integrated digital and physical care platforms combine telemedicine with brick and mortar providers, such as Ochsner’s partnership with Hims.
• Tech infrastructure platforms such as AWS, Google Cloud, Salesforce, and Microsoft Azure that healthcare companies plug into to support information management and virtual care.

Looking under the hood

The platforms taking shape today will create staying power, to varying degrees, by leaning on three pillars: technology backbone, user experience, and clinical expertise.

1. Technology backbone: digital health infrastructure is maturing, lowering barriers to entry

Initially making a play in digital health required building all the base technology and infrastructure required for your product. However, after a decade of steadily rising investment, many of these building blocks have been built, bringing a level of maturity to the market. For example:

• Remote pharmacy infrastructure. Many of the convenience care platforms are powered by delivery pharmacy infrastructure that consumers have never heard of. For example Nurx, Hims, and GoodRx, are using Truepill to fulfill and deliver prescriptions nationally, enabling them to focus on their consumer experience.
• Data integration. Data integration companies such as Redox, Datavant, and Particle Health have created linkages to EMRs across the country, taking the heavy lifting out of patient data exchange. A slew of companies are building upon this, from digital therapeutics company Voluntis integrating into clinical workflows to Seqster partnering with Datavant to offer an RWD product. As Troy Bannister CEO of Particle Health explains, “For the first time in history, developers have a unified platform and experience to build healthcare solutions on top of the US Health System.”
• Biomarker tracking. Some of the big tech firms have been working on biomarker technology that other apps can plug into, with Apple Health Kit as an obvious example. The number of biometric trackers have proliferated in recent years, creating challenges for healthcare organizations that want to monitor patients remotely. Elektra Labs provides operational and data governance support to these organizations by helping them decide what they should measure and which technology to use. As Andy Coravos, CEO of Elektra told us, “a lot of our work is around foundation building—helping people get an understanding of these tools, security, and data rights.” Building out this infrastructure further, the company is currently working on what Coravos describes as a “operations management” solution.

2. Consumer experience: targeting a specific user base and designing around their needs opens new markets

Healthcare is a late comer to the consumer experience game, but it’s starting to catch up. Disruptors are designing their platforms to attract and retain users whose expectations have been shaped outside of the healthcare industry. Moving away from one-size-fits-all, platform companies are identifying and addressing the specific needs and preferences of defined customer segments.

• Convenience care platforms such as Ro, Hims, and Nurx focus on episodic convenience and access, using asynchronous telemedicine and subscription services combined with a light touch of physician interaction.
• Care management platforms such as Omada, Vida, and Kaia focus on longitudinal engagement complemented by a human touch to drive outcomes.
• Omnichannel retail health players such as Walmart and Best Buy are building upon their familiar in-store experience and local brick-and-mortar footprint to provide healthcare to their existing customer base.

3. Clinical expertise: ability to drive outcomes is a differentiator, but clinical expertise can be built in different ways

This is digital health after all, so some of these platforms will win on the strength of their clinical expertise. New entrants to healthcare (startups or non-healthcare disruptors) have to decide whether they will build, buy, or partner to gain their clinical expertise—and that decision often depends on how core clinical expertise is to their product.

• Care management startups like Omada and Virta usually build their clinical approach to create a differentiator and prove outcomes.
• Omnichannel retail players from outside healthcare usually buy their clinical capabilities, such as Best Buy acquiring Great Call and Critical Signal Technologies.
• Integrated digital and physical care platforms are often based on partnerships with providers, such as Hims partnering with Ochsner and Privia Health.

The billion dollar question

In addition to these pillars, what makes the platform wars really interesting is the different business models in play—even amongst companies building similar platforms. Who is paying for your services? What do you own—technology, hard assets, or human capital? What IP are you building? The winners in the platform wars will make critical decisions within each pillar that support their own unique business model.