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

by Vince Kuraitis and Neil P. Jennings of Untangle Well being

Right here’s an overview of at this time’s weblog put up:

• A Temporary Recap: What are UDHPs?
• Thesis: EHRs Can Develop to Grow to be UDHPs
  1. EHRs At present Personal the Buyer Relationship
  2. Many Clients Have an “EHR-First” Desire for New Purposes
  3. Epic and Oracle Well being are Making Robust Actions Towards Turning into UDHPs
• Antithesis: EHRs Can NOT Grow to be Efficient EHRs
  1. EHRs Carry a Lot of Baggage
  2. Clients are Skeptical
  3. EHR Analytics Are NOT Optimized To Obtain Essential Well being System Targets
  4. EHR Switching Prices are Diminishing
  5. Cloud Native Platforms Speed up Innovation and Efficiency
  6. It’s Not in EHR DNA to Grow to be A Broad-Primarily based Platform
• Synthesis and Conclusion

This can be a lengthy put up…over 4,000 phrases…so we’ve clearly obtained lots to say on the matter. Hope you introduced snacks!

A Temporary Recap: What are UDHPs? (Unified Digital Well being Platforms)

In our previous extensive post on UDHPs, we described them as a brand new class of enterprise software program. A December 2022 Gartner Market Information report characterised the long-term potential:

The [U]DHP shift will emerge as probably the most cost-effective and technically environment friendly strategy to scale new digital capabilities inside and throughout well being ecosystems and can, over time, substitute the dominant period of the monolithic digital well being file (EHR).

The DHP Reference Structure is illustrated in a blog post by Better. Notice that UDHPs are visually depicted as “sitting on prime” of EHRs and different siloed sources of well being knowledge:

We famous that just about any kind of enormous healthcare group — well being techniques, well being plans, pharma corporations, medical system corporations, and many others. — had a necessity for UDHPs. Nonetheless, at this time’s focus is extra slim — we restrict the dialogue to UDHPs in hospitals and well being techniques, primarily within the U.S. We use the time period “well being system” to embody hospitals and regional well being supply techniques.

On this put up, we deal with the 2 largest EHR distributors within the U.S. — Epic and Oracle Well being; they’ve a combined market share of 65% of hospitals and 77% of hospital beds.

Within the remaining sections, we are going to lay out arguments on each side of the problem of whether or not EHRs can (or can’t) develop to turn into UDHPs. The graphic beneath is our crack at a visible abstract. The balloons symbolize the thesis – that EHRs can develop to turn into UDHPs; the anchors symbolize the antithesis – that EHRs cannot develop to turn into UDHPs.

Thesis: EHRs Can Develop To Turning into UDHPs

Let’s take a look at the case for EHRs increasing to turn into efficient UDHPs.

1) EHRs At present Personal the Buyer Relationship

Fueled by federal HITECH incentives and mandates, well being techniques have made important investments of their current EHRs:

• As of 2021, 96% of non-federal acute care hospitals within the U.S. had adopted an authorized EHR.
• They made big capital commitments to buy and set up their EHR, typically lots of of tens of millions of {dollars}.
• Many current medical workflows are constructed on EHRs.
• A majority of a affected person’s medical knowledge in a well being system resides inside their EHR.

In line with SoftwareReviews, Epic and (Oracle) Cerner Millennium EHRs obtain good to excessive rankings from well being system prospects.

Thus, any new vendor making an attempt to promote new healthcare enterprise software program (i.e., a UDHP) will face a excessive hurdle: “We have already got an EHR…why ought to we think about you?”

2) Many Clients Have an “EHR-First” Desire for New Purposes

Well being techniques have been making an attempt to remain afloat in a veritable tsunami of point solutions. This creates a variety of challenges, together with:

• Complexity and integration challenges
• Regulatory and compliance dangers
• Fragmentation of care
• Consumer adoption and coaching
• Value and ROI issues

As proven within the graphic beneath, a 2024 Bain & Company/KLAS survey of well being techniques discovered that 81% more and more plan to look to current distributors earlier than contemplating choices from new distributors.

Extra particularly, the survey discovered that 79% plan to look to their EHR vendor first for brand new options earlier than seeking to others.

University Hospitals is an instance of a well being system with an EHR-First technique. In line with Robert Eardley, CIO, this guideline ensures the well being system prioritizes instruments and improvements out there inside its Epic digital well being file platform each time possible.

3) Epic and Oracle Are Making Robust Actions Towards Turning into UDHPs

Maybe one of the best argument that EHRs are able to turning into Unified Digital Well being Platforms is that Epic and Oracle Well being are already making daring strikes. Let’s check out them individually.

Epic’s EHR Growth Plans

Epic is greater than a fundamental EHR — it affords current prospects a broad base of capabilities. Interop guru Brendan Keeler has written extensively about Epic. In his article “An Epic Saga: The Origin Story” he describes how Epic grew to its present dimension. The Appendix offers an intensive record of “Epic Modules.”

In an insightful 2024 analysis of Epic’s dominant market position, Seth Joseph included a listing of Products You Can Replace with Epic. The record included over 150 capabilities “that can assist you determine areas the place you could possibly use your Epic software program to both substitute or keep away from buying area of interest functions…”

Epic is also increasing new choices to new buyer classes. Within the article “Epic Beyond the Provider Empire“, Brendan Keeler offers an in depth record:

Well being Grid — software program offered to

• Labs
• Medical system corporations
• Payers
• Telehealth corporations
• Medical trials

Well being Grid Adjoining choices

• Cosmos — “an enormous medical dataset created by pooling data from Epic well being techniques”
• Payer Gateway — a “lighter-weight service for payers that permits them to obtain medical knowledge from Epic healthcare organizations”
• Chart Gateway — “Epic’s service that streamlines how life insurance coverage corporations get medical information from Epic healthcare organizations”
• EpicCare Hyperlink — “a web-based portal product that lets Epic healthcare organizations supply non-Epic suppliers a strategy to work together with them.”

Different stuff

• Provide Store — providers choices
• Revcyclers — “Third events working with Epic and supply billing providers to assist enhance income cycle outcomes”
• Cornerstone Companions — deep relationships with Microsoft and InterSystems

However wait…there’s extra. At HIMSS 2025, Epic announced extra AI capabilities within the works and that it’s creating a healthcare-specific enterprise useful resource planning (ERP) system. Whereas we view an ERP as an enormous stretch, it’s additionally a possible game-changer for Epic.

Utilizing a framework created by David Yuan of Tidemark, Brendan Keeler capsulized Epic’s broader platform technique:

With additions just like the ERP, Epic is clearly evolving past a conventional EHR system, however is it sufficient to fulfill the UDHP wants of contemporary well being techniques?

Oracle Well being Goes Past Being a Conventional EHR

In October 2024, Oracle announced a brand new EHR. As described by the corporate, Oracle Health has many traits that make it look extra like a UDHP than a conventional EHR. It goals to go considerably past the capabilities of a conventional EHR:

1. Embedded Synthetic Intelligence (AI): Not like EHRs the place AI is commonly a bolt-on, Oracle’s new system is designed with AI as a core part, built-in throughout your complete medical workflow. This features a Medical AI Agent, AI-driven insights on the level of care, AI-powered summaries, and customized care plans.
2. Enhanced Consumer Expertise: Recognizing the clinician burden related to conventional EHRs, the brand new system emphasizes an intuitive and user-friendly design with options like voice-driven navigation and search, multimodal search, and a customizable interface.
3. Oracle Well being Knowledge Intelligence is an AI and analytics answer embedded throughout the EHR, enabling integration of disparate knowledge sources, real-time insights, and inhabitants well being administration instruments.
4. Subsequent-Era Oracle Cloud Infrastructure affords benefits of enhanced safety, scalability, and efficiency, and higher knowledge change.
5. Affected person Engagement Instruments: The brand new EHR features a reimagined affected person portal centered on empowering sufferers to entry and management their medical historical past, facilitating communication with suppliers, and enabling self-service capabilities for sufferers to handle appointments, pay payments, and entry well being data.
6. Concentrate on Worth-Primarily based Care: The system is designed to help value-based care fashions by streamlining data change between payers and suppliers, enhancing care coordination, and offering insights into price and useful resource allocation.

Oracle Well being goals to maneuver past being a system of file to turning into a system of motion — an clever, built-in platform that actively assists clinicians, engages sufferers, and drives higher outcomes in a extra environment friendly and safe method. Oracle’s most recent announcement of a platform partnership with Cleveland Clinic and G42 is according to the migration towards turning into a UDHP.

Oracle Well being remains to be in its early phases of a roll-out, with an early adopter program launched in 2025. Subsequently, intensive, broadly printed surveys and large-scale buyer suggestions about this new platform aren’t but out there.

Antithesis: EHRs Can NOT Grow to be Efficient UDHPs

Now let’s look at arguments suggesting that EHRs aren’t able to turning into well being techniques’ “platform of platforms” — a UDHP.

1) EHRs Carry a Lot of Baggage

Right now’s EHRs are criticized on quite a lot of fronts: errors and safety issues, cost, lack of competition, lack of interoperability, and lack of usability for clinicians.  COVID-19 highlighted lots of the weaknesses in EHRs as being “massive, sluggish monoliths that don’t shortly adapt to new, emergent calls for on their design and workflow.”

However what in regards to the excessive satisfaction scores beforehand cited? EHRs usually tend to think about well being system directors as their “prospects.” As famous above, clinician “consumer” satisfaction is mostly low.

Distributors even have allowed prospects to customise EHR implementations. Native customization results in substantial variations in how the system operates from one web site to a different. The customarily-used colloquial phrase is that there are “50 dialects of Epic.” Whereas some extent of EHR customization is critical and may improve clinician buy-in, over-customization may end up in problem interoperating, as knowledge definitions and workflows can differ enormously. With every EHR occasion probably distinctive, extending EHRs to turn into UDHPs carries ahead organization-specific configurations which can lead to substantial longitudinal upkeep (for both the well being system or the companions related to the EHR).

Lastly, Epic’s distinctive dimension and dominant market place may appeal to antitrust challenges from authorities regulators. Even at this time, as Seth Joseph documents, Epic is already attracting lawsuits from a number of “smaller, adjoining distributors.” As Epic provides ERP and Cerner and Epic proceed including adjoining options and capabilities, they’re increasing their positions, probably garnering extra regulatory oversight.

2) Clients are Skeptical

Even whereas many well being techniques might need an “EHR-First” integration choice, many are additionally skeptical of their EHR vendor’s guarantees and their means to combine new apps. Sage Development Companions report entitled The New Healthcare C-Suite Agenda: 2024-25 addressed the problem:

C-Suites are at a expertise crossroads: Only a few are happy with their EMR vendor, the market is flooded with level options however integrations are irritating staff extra, and regardless of the coverage relaxations round telehealth over the last three years, telehealth and in-home hospital instruments usually are not effectively built-in with EMRs.

When requested “How effectively does your present vendor stay as much as the guarantees it makes in regards to the EMR, solely 26% responded “extraordinarily effectively” or “very effectively.”

Maybe most significantly, “𝐨𝐧𝐥𝐲 𝟏𝟕% 𝐨𝐟 𝟐𝟎𝟐𝟑 𝐫𝐞𝐬𝐩𝐨𝐧𝐝𝐞𝐧𝐭𝐬 “𝐬𝐭𝐫𝐨𝐧𝐠𝐥𝐲 𝐚𝐠𝐫𝐞𝐞” 𝐭𝐡𝐚𝐭 𝐭𝐡𝐞 𝐄𝐌𝐑 𝐰𝐢𝐥𝐥 𝐦𝐞𝐞𝐭 𝐭𝐡𝐞 𝐦𝐚𝐣𝐨𝐫𝐢𝐭𝐲 𝐨𝐟 𝐭𝐡𝐞𝐢𝐫 𝐨𝐫𝐠𝐚𝐧𝐢𝐳𝐚𝐭𝐢𝐨𝐧’𝐬 𝐧𝐞𝐞𝐝𝐬 𝐦𝐨𝐯𝐢𝐧𝐠 𝐟𝐨𝐫𝐰𝐚𝐫𝐝, down from 25% in 2022.”

3) EHR Analytics Are NOT Optimized To Obtain Essential Well being System Targets

Any particular person EHR can NOT be considered because the “supply of reality” for a affected person’s medical historical past:

A number of EHR Distributors. Each within the U.S. and overseas, bigger well being techniques typically are Frankenstein’s monsters stitched collectively from numerous acquisitions. Thus, they regularly sport a patchwork of competing EHRs. A HIMSS Analytics study discovered that the common well being system has 18 completely different EHR distributors throughout inpatient and outpatient settings.

A number of Level Options and Sources of Knowledge. Affected person knowledge in well being techniques is unfold throughout a number of techniques, not simply EHRs.

Affected person and Knowledge “Leakage.” Right now’s sufferers are extra motivated by comfort than loyalty to 1 well being system; affected person leakage throughout care suppliers is critical. A research in International Journal of Medical Informatics discovered that “solely 4.5 % of expenditure-weighted particular person Medicare beneficiaries had their MU medical information related to a single vendor, whereas 19.8 % of expenditure-weighted beneficiaries had their MU medical information saved in 8 or extra distributors.”

Affected person Well being and Care Knowledge is More and more Outdoors of EHRs. A McKinsey study examined how a lifetime of affected person well being and care knowledge is prone to be created (see the graphic beneath).

By including the numbers in the appropriate column, you’ll see that an individual generates an estimated whole of 1,106.4 terabytes of well being knowledge over the course of a lifetime. Nonetheless, solely 0.4 terabytes — or 0.04% — is medical knowledge, i.e., prone to reside in at this time’s EHRs.

The implication: EHRs are prone to include solely a fraction of a affected person’s well being and care knowledge. Optimum end-to-end analytical techniques for affected person knowledge — ones designed for each prevention and care – might want to pull knowledge from throughout a various vary of sources. These capabilities don’t exist in at this time’s EHRs.

We’ve famous that the roots of EHRs are as techniques of file to doc processes for fee-for-service billing, but it surely goes deeper than that.

Pushed by early incentives like Significant Use, EHR design closely prioritized billing for particular person providers and administrative duties. Consequently, their structure emphasised documenting the quantity of care delivered for reimbursement, moderately than the worth of affected person outcomes and effectivity.

The restricted interoperability inherent in lots of early EHR techniques fostered knowledge silos. This fragmentation made it troublesome to realize the excellent, holistic affected person view important for efficient value-based care (VBC) and value-based funds (VBP), care coordination, inhabitants well being administration, whole price of care measurement and administration, and different capabilities wanted for cutting-edge well being techniques.

In flip, conventional EHRs usually lacked entry to longitudinal claims knowledge and the delicate analytics essential to robustly measure prices and affected person outcomes. Additionally they regularly lacked standardized mechanisms for capturing patient-reported outcomes (PROs) and didn’t streamline medical workflows to particularly help value-focused care supply. In consequence, these techniques weren’t inherently designed to optimize for the ideas and various cost fashions of VBC.

Whereas EHR expertise has superior, these foundational limitations proceed to current important hurdles for well being techniques navigating the advanced transition in direction of VBC and inhabitants well being. Addressing these inherent design constraints is essential for realizing the complete potential of digital well being in a future-proofed, value-driven healthcare panorama.

4) EHR Switching Prices are Diminishing

Previously, switching EHRs was akin to transferring homes throughout a blizzard…with three toddlers and a herd of goats. Excessive switching prices created a defensive moat to guard EHRs from rivals, both different EHRs or a brand new class of UDHPs.

Nonetheless, authorities coverage, laws, and regulation over the previous twenty years have promoted interoperability and applicable change of affected person knowledge. The HITECH Act, the twenty first Century Cures Act, the promotion of HL7 FHIR APIs, and the creation of TEFCA exemplify this pattern.

As affected person knowledge turns into extra fluid and readily shareable throughout completely different techniques, switching prices are diminished. That is much more pronounced exterior the U.S., the place requirements like openEHR – a standardized medical knowledge mannequin which separates knowledge from functions – are gaining traction, demonstrating the potential of information standardization to ease system transitions. The EU Data Act mandates the power to modify knowledge suppliers seamlessly.

Moreover, the evolution in direction of a UDHP doesn’t essentially require a whole and quick EHR alternative. As we mentioned in a previous blog post, UDHPs will be architected to combine with and leverage current knowledge repositories, together with EHRs. This incremental strategy to UDHP adoption can considerably scale back the perceived and precise prices of transitioning to a extra unified digital well being ecosystem.

5) Cloud Native Platforms Speed up Innovation and Efficiency

The roots of EHRs are as techniques of file to doc fee-for-service billing processes, changing on-site processes with (usually) on-prem software program. UDHPs, then again, are usually cloud native software program, permitting broad scalability, availability, and performing as hubs for innovation. With CHIME’s 2024 survey suggesting “24% of CIOs highlighted applicational rationalization and optimization a prime precedence,” this begs the query: the place ought to this utility rationalization and optimization happen?

Cloud native software program is a powerful contender, providing lots of the CIO-sought advantages and the power to scale in a cost-transparent method. Neil’s latest piece “Head in the Cloud: Today’s Healthcare Executive” covers the shift to cloud-first infrastructure on account of extra than simply market wants, but in addition a change in management. Because the Epic-selecting CIOs of the 2010s are retiring, a brand new technologist profile is rising and leaning cloud-first.

To be clear, we’re not referring to easily lifting-and-shifting an EHR from on-prem to the cloud. Whereas altering internet hosting suppliers and areas can add incremental advantages to efficiency, price of possession, and scalability, the complete advantages of cloud-first platforms usually are not achieved by migrating legacy software program.

To get the complete advantages of a cloud-first strategy, there’ll should be a re-architecture of techniques. This can be a massive process, however now we have lots of the items at this time, with scalable databases, Grasp-Knowledge-Administration merchandise, EMPI merchandise, and headless EHRs (ONC Licensed EHRs of file that let prospects to reskin the affected person and provider-facing experiences). Some main organizations are already creating cloud-hosted centralized knowledge platforms that create a single supply of reality, brokering knowledge throughout their technical ecosystem. Under, we’ll cowl some main advantages of this extra encompassing cloud-first strategy.

 

The place EHR distributors have traditionally moved slowly, cloud service suppliers are quickly including shared providers and tooling. With their consumption-based pricing fashions, they’re straight incentivized to allow and encourage onboarding new customers, use instances, functions, and databases. Not everybody will want or need to construct from scratch within the cloud, and as highlighted within the earlier put up, cloud-hosted ERP platforms are additionally rising to the event to fulfill UDHP wants.

Past the record of advantages above, it’s the strategy of those new service suppliers that encourages us to query whether or not EHRs can stay UDHPs in the long run. The cloud service suppliers (or hyperscalers) and ERPs are prepared to combine with anybody, host and provision something anyplace, and supply centralized, distributed accessible, – and likewise open – techniques. AWS and Azure, for instance, would fortunately host your Epic occasion, connect with your athenaHealth tablespace, and your level options. Please, proceed including extra!

And, they’ve probably the most superior, scalable databases and knowledge platforms to accommodate that knowledge. This makes the following technology of level options, CDS options, or AI-derived brokers even simpler to create as cloud-first, as the info are already there, centralized, and accessible.

EHR prospects are additionally flocking to cloud distributors already, seeing advantages in internet hosting prices, scalability, testing, and different areas. From KLAS’ Epic within the Public Cloud 2024 report: “The bulk [of survey respondents] make the most of a cloud supplier for Epic catastrophe restoration, and this typically serves because the preliminary step within the Epic cloud migration journey.” IDC takes it a step additional of their 2024-2025 Well being Knowledge Platforms for Suppliers Vendor Evaluation, introducing multi-cloud implementations as a doable route, stating that “Practically half (49.2%) of U.S. healthcare suppliers will prioritize IT modernization initiatives extending into 2025. This emphasizes the necessity for platforms that scale successfully and combine seamlessly with current and rising techniques within the healthcare ecosystem. Multicloud adaptability can be important to attaining this.“

This implies one reply to the query of the place utility rationalization and optimization ought to happen: within the cloud. The cloud distributors are prepared and capable of accommodate any EHR and are aligning incentives to speed up cloud adoption. If these cloud platforms can handle healthcare’s knowledge complexity, what’s stopping them from being the UDHPs accelerating innovation in healthcare?

6) It’s Not in EHR DNA to Grow to be a Broad-Primarily based Platform

EHRs are set of their methods – kinda like your uncle who nonetheless makes use of a flip cellphone. Not like lots of at this time’s most profitable tech corporations, EHRs usually are not “platform native.” We record some potential methods this might inhibit an EHR’s growth towards turning into a UDHP:

“Software program Considering” vs. “Platform Considering.” To actually perceive the transformative potential of Unified Digital Well being Platforms, it’s essential to differentiate between conventional “software program pondering” and extra expansive “platform pondering.” By their very definition, UDHPs aren’t merely new software program; they symbolize a basic shift in direction of a platform enterprise mannequin, full with a new set of rules requiring a unique mindset for fulfillment.

Seth Joseph astutely noticed that EHRs nonetheless consider themselves as software program corporations, whereas the larger alternative is emigrate from being “a software program vendor within the market to {the marketplace} itself.” This transition necessitates a basic change in how these techniques are conceived, constructed, and operated.

Growth Via In-Home Improvement vs. Growth Via M&A. Traditionally, Epic has largely favored growth by way of in-house growth moderately than embracing the platform technique of progress by way of acquisitions and fostering an exterior ecosystem. Judy Faulkner, the influential founding father of Epic, has famously said Epic won’t ever be offered and has additionally traditionally maintained a stance towards buying different corporations.

This inward focus contrasts sharply with the strategy of established platform giants who’ve made lots of of acquisitions:

Alphabet (Google) — 200+

Amazon — 125+

Meta — 100+

Microsoft — 275+

To scale successfully and exponentially, it’s essential to take an ecosystem-first strategy.

Foot-Dragging On Interoperability vs. Interoperability by Default. The early historic strategy of many EHR distributors has been characterised as foot-dragging on interoperability, a stark distinction to the “interoperability by default” ethos of profitable platform companies.

Constructing One Firm vs. Constructing an Ecosystem of Companions. Lastly, till the previous decade the standard EHR mannequin was operated below the belief that exterior builders weren’t really mandatory, a viewpoint diametrically against the platform enterprise mannequin the place builders are central.

In 2017, Epic opened its app retailer to a sluggish begin. Epic was considered as unresponsive by many app builders. We additionally bear in mind builders claiming that Epic was not respecting their mental property rights, i.e., “Your IP is now our IP.”

Epic has since developed far more vibrant developer applications. In but another blog post, Brendan Keeler describes and charges builders’ choices in working with Epic. He concludes by advising devs to “mood your expectations.”

Synthesis and Conclusion:

OK, we’ll admit that the Thesis/Antithesis factor was a little dramatic. Let’s revisit the wording:

• Thesis: EHRs Can Develop To Turning into UDHPs
• Antithesis: EHRs Can’t Grow to be Efficient UDHPs

We’ll additionally concede that the wording is a bit deceptive — it implies black/white situations below which EHRs both will or won’t turn into UDHPs. The fact, as at all times, is messier than a binary selection. It’s not ‘EHRs will completely turn into UDHPs’ or ‘EHRs are doomed to the dustbin of historical past.’ It’s extra like…shades of grey, with a wholesome dose of ‘we’ll see.’”

The UDHP market may be very early — the Gartner report that we cited in our previous blog post on UDHPs estimated that the market is simply 5% penetrated and that UDHP adoption will take 5 to 10 years.

As we’ve famous, UDHPs will be adopted incrementally and over time. UDHPs can accommodate EHRs as parts, and UDHPs and EHRs usually are not mutually unique: we don’t see EHRs as going away any time quickly.

We anticipate that completely different organizations will make completely different selections, relying on quite a lot of components similar to:

• Dimension and assets. Bigger well being techniques probably will see better wants for a UDHP; smaller techniques extra probably will look to their EHR for integrations.
• Organizational complexity and geographic footprint. Multi-state footprints, a mixture of care settings throughout the acuity spectrum, and vast ranges of specialties all add complexity, required connections, and extra alternative with a UDHP strategy.
• Present EHR vendor. Some EHR distributors would possibly succeed at creating UDHP capabilities, others may not. TBD.
• Pricing of UDHPs vs. EHRs. TBD.
• Evolution of UDHP capabilities and market acceptance. TBD.
• UDHP vendor and market evolution. In our earlier put up, we highlighted over 20 UDHP vendor “candidates”, and later recommended that this quantity would shrink drastically.

In our subsequent put up on this collection, we’ll section the healthcare supplier market to judge for whom (which hospitals and well being techniques) the EHR may function the UDHP and when it is smart to decide on a cloud-first answer.

Vince Kuraitis JD/MBA is an unbiased marketing consultant with over 35 years’ expertise throughout 150+ healthcare & tech corporations.   Neil Jennings is Vice President, Consulting at Untangle Health. Vince publishes The Healthcare Platform Blog, the place this put up first appeared. The authors need to thank a number of colleagues for his or her evaluate and commentary on an earlier draft of this put up: Michael Byczkowski, International Head of Healthcare at SAP; Brendan Keeler, Interoperability Apply Lead at HTD Well being; Sandra Raup, President at Datuit; and Chris Notaro, CEO of Untangle Well being.