The three categories of technology providers, namely Custodians, Enablers, and Arbitrageurs have stopped short of building ready-to-deploy digital health experiences, which leads us to the Last Mile problem in healthcare. Custodians are the big electronic health record (EHR) vendors, Enablers are big technology firms that develop technology stacks which include inbuilt advanced analytics capabilities that can deliver insights to power digital health experiences, and the Arbitrageurs are mostly technology agnostic consulting firms. So what causes the last mile problem?
Extended cycles to hit prime time usage: Most health systems follow a traditional approach that takes promising new solutions through the phases of a free pilot, paid pilot, and enterprise adoption. The process could take years, and many solutions remain in “pilot purgatory” for an extended period, often failing to break through to enterprise adoption. Health systems need a newer, more agile model, to assess and deploy promising solutions more quickly and efficiently
Too many standalone solutions: The digital health landscape is littered with thousands of point solutions that stand in isolation, with no established connectivity to systems of record which is the price of entry for any new solution. Health systems are loath to sign up dozens of point solutions and take on the burden of integrating and managing these solutions. They prefer to default to the many solutions that EHR vendors have built or are actively building (or claim to be building) that effectively make stand-alone solutions redundant, despite the superior experience architectures that startups are known for. A potential approach for startups is to align with one of the big Enabler companies who, through established relationships with health systems, can create a pathway to adoption and growth.
An absence of scale: No single platform addresses all the needs of a digital health enterprise today, unlike the mature enterprise resource planning (ERP) systems of the manufacturing and financial sectors. There is a significant opportunity for Enabler companies to build ready-to-deploy innovation ecosystems through partnerships with digital health startups. However, Enabler platforms too have increased and are at risk of becoming too fragmented to present a real alternative to health systems looking for scale and velocity in the digital transformation journeys.