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Opening Keynote A Manifesto for Healthcare’s Disruptive Innovation of
Opening Keynote A Manifesto for Healthcare’s Disruptive Innovation of
Opening Keynote A Manifesto for Healthcare’s Disruptive Innovation of
Opening Keynote A Manifesto for Healthcare’s Disruptive Innovation of
Opening Keynote A Manifesto for Healthcare’s Disruptive Innovation of
Opening Keynote A Manifesto for Healthcare’s Disruptive Innovation of
I. A Case Study in Disruptive Innovation: Apple iPhone & Google
I. A Case Study in Disruptive Innovation: Apple iPhone & Google
5
5
5
5
5
5
iPhone + Android Share of Smartphone Internet Usage April 08: 6%
iPhone + Android Share of Smartphone Internet Usage April 08: 6%
Walled Garden
Walled Garden
iPhone Revenue Q2:07 $5M Q1:10 $5
iPhone Revenue Q2:07 $5M Q1:10 $5
12
12
Google Android Operating System-- Open Platform
Google Android Operating System-- Open Platform
15
15
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Result: A Vibrant, Competitive Ecosystem
Modularity: Dis-Integration of the Computer Industry
Modularity: Dis-Integration of the Computer Industry
Modularity: Dis-Integration of the Computer Industry
Modularity: Dis-Integration of the Computer Industry
From EMR 1.0
From EMR 1.0
.... EHR 2.0/ Clinical Groupware v1
.... EHR 2.0/ Clinical Groupware v1
From 1) Closed to 2) Walled Gardens to 3) Open Platform(s)
From 1) Closed to 2) Walled Gardens to 3) Open Platform(s)
23
23
A taxonomy of “open” (one example)
A taxonomy of “open” (one example)
A taxonomy of “open” (one example)
A taxonomy of “open” (one example)
2) TODAY: “Walled Garden” EHR Platforms
2) TODAY: “Walled Garden” EHR Platforms
31
31
31
31
3 Elements for Disruptive Innovation
3 Elements for Disruptive Innovation
...early spring flowers ready to burst forth in a blossom of
...early spring flowers ready to burst forth in a blossom of
Value Creation vs
Value Creation vs
The Value of the Clinical Groupware Collaborative
The Value of the Clinical Groupware Collaborative
Stages 2 & 3 of HITECH “Meaningful Use” will be a bonanza for the HU
Stages 2 & 3 of HITECH “Meaningful Use” will be a bonanza for the HU
Stages 2 & 3 of HITECH “Meaningful Use” will be a bonanza for the HU
Stages 2 & 3 of HITECH “Meaningful Use” will be a bonanza for the HU
A Thousand Flowers of Innovation In Full Blossom
A Thousand Flowers of Innovation In Full Blossom
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A Manifesto for Healthcares Disruptive Innovation of the Decade: Open EHR Technology Platform(s) and Ecosystem

содержание презентации «A Manifesto for Healthcares Disruptive Innovation of the Decade: Open EHR Technology Platform(s) and Ecosystem.ppt»
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1Opening Keynote A Manifesto for 27Eclipsys Eclipsys Introduces Open Platform
Healthcare’s Disruptive Innovation of the to Transform Health IT and Drive
Decade: Open EHR Technology Platform(s) Electronic Health Record Adoption 3/10 GE
and Ecosystem. Vince Kuraitis JD, MBA GE IT CEO touts debut of next-gen clinical
Better Health Technologies, LLC knowledge platform, eHealth Platform 3/10
http://e-CareManagement.com blog (208) Henry Schein Henry Schein Announces the
395-1197. Launch of Innovative Henry Schein
2Overview. A Case Study in Disruptive ConnectHealth (TM) Collaborative 3/10
Innovation: Apple iPhone & Google Medecision MEDecision Webinar Will
Android A Manifesto for Healthcare: Open Introduce New InFrame Collaborative Health
EHR Tech Platform(s) and Ecosystem Information Service Technology 3/10
Yesterday -- Closed Today -- Walled Garden Medicity Medicity Opens Its Health
Tomorrow -- Open Implications for the Information Exchange Platform to
Healthcare Unbound Community Note: Third-party Application Development 11/09
Graphics referencing articles/reports Microsoft/Eclipsys Microsoft and Eclipsys
contain hyperlinks to the original source. Announce Health Care IT Alliance 2/10
2. Navinet NaviNet Offers End-to-End
3“Chances are you’re an app”. Is your Healthcare Communications Platform 2/10
company a platform? an application? both? Quest Diagnostics Quest Diagnostics
Simple view of apps Apps need access to Unveils Care360 EHR 3/10 Verizon Verizon
data about patient Perform Launches IT Platform to Help Accelerate
process/intervention Deliver data back to Adoption of Electronic Health Care Records
health record Provocative assertion: 3/10. 27.
Almost every healthcare service or product 28Will WG platforms result in
can function as an “app”. 3. innovation? How will app vendors view WG
4I. A Case Study in Disruptive platforms? 13+ platforms! Cost/time to get
Innovation: Apple iPhone & Google up learning curve with each platform? How
Android. 2 Success Stories Growth Value easy is the API to learn/use? How are
Competitive Ecosystem. 4. revenues split? Which platform(s) have
55. market viability? Likely winners unclear
6iPhone + Android Share of Smartphone High transaction costs of exploring
Internet Usage April 08: 6% February 10: options Wait and see? 28.
86%. 6. 29From 1) Closed to 2) Walled Gardens to
7Walled Garden. 7. 3) Open Platform(s). 3. 2. 1. 29.
8What’s a Walled Garden (WG)? Controls 303) Tomorrow?: Open EHR Technology
users’ access to content and services Platforms with Plug-and-Play Modular Apps.
Restricts the user’s navigation within Open at many levels (not necessarily all)
particular areas (applications) Not all API Patient ownership of data Data
alike: differing heights and levels of portability Open standards Open source
permeability to the walls. 8. Cross-platform apps Low barriers to
9Walled Garden (WG): Apple iPhone. entry/restrictions for developers etc. 30.
Chronology March 7, 2007: Apple introduces 3131. Technology platforms that support
iPhone “product” March 2, 2008: Apple substitutable applications should be
opens API to developers March 6, 2008: promoted. Messages and protocols for data
100,000 downloads of SDK Kleiner, Perkins exchange should be allowed to emerge on
announces $100 M investment fund November demand in a market-driven approach, and
4, 2009: 100 K apps July 2010: 225 K apps. specified transparently at every level.
9. Protocols and application programming
10Business model Open API Virtually interfaces should allow the possibility of
every other aspect closed Integrated multiple platforms co-existing.
hardware/software platform Non-swappable Application programming interfaces should
applications Exclusive distribution of be open. Substitutable application or
apps. Restriction on carrier choice platform vendors should not have control
Restrictions and controls on developers over what is installed on the platform
Multiple revenue sources -- HW $$, Application installation should be
developer $$, app store Highly controlled turnkey. The intellectual property of
user experience. 10. platforms and applications should be kept
11iPhone Revenue Q2:07 $5M Q1:10 $5.5B. separate. All applications should be
11. removable and none should be required to
1212. run a platform. The platform should have a
13Google Android Operating System-- Open highly efficient delivery mechanism for
Platform. Open Handset Alliance: 30+ applications. Certification requirements
companies Google Android open source SW for platforms and applications should be
Multiple handset developers bring hardware kept minimal to maximize substitutability.
Open API 20+ smartphones on the market use Android-like.
Android OS 70+ K Android apps Google 323 Elements for Disruptive Innovation.
maintains “control points”, e.g., see MIA. Technological enabler. Typically,
http://www.visionmobile.com/blog/2010/04/i sophisticated technology whose purpose is
-android-evil/. 13. to simplify, it routinizes the solution to
14Google can give away Android problems that previously required
because... “...we make money, and lots of unstructured processes of intuitive
it, it turns out, from advertising on experimentation to resolve. Business model
mobile phones.” Eric Schmidt, CEO, Google. innovation. Can profitably deliver these
14. simplified solutions to customers in ways
1515. that make them affordable and conveniently
16Result: A Vibrant, Competitive accessible. Value network. A commercial
Ecosystem. 16. infrastructure whose constituent companies
17II. A Manifesto for Healthcare: Open have consistently disruptive, mutually
EHR Tech Platform(s) and Ecosystem. 17. reinforcing economic models. 32.
18Modularity: Dis-Integration of the 33...early spring flowers ready to burst
Computer Industry. 18. Source: forth in a blossom of innovation. 33.
Venkatraman, N. Winning in a Network 34Drivers Toward an Open EHR Technology
Centric Era, 2006. Platform. The Office of the National
19From EMR 1.0 ... 19. Coordinator for Health IT (ONC). …we
20.... EHR 2.0/ Clinical Groupware v1.1, believe that it will be common in the near
June 2009. 20. future for Certified EHR Technology to be
21Yesterday: Closed/Monolithic Today: assembled from several replaceable and
Walled Garden EHR Platforms Tomorrow?: swappable EHR Modules. Health & Human
Open EHR Technology Platform(s) with Services, Interim Final Rule on Standards
Plug-and-Play Modular Apps. Evolution of , December 2009 p.41 Google Health and
EMR/EHR Technology. 21. Microsoft HealthVault The Clinical
22From 1) Closed to 2) Walled Gardens to Groupware Collaborative Free or freemium
3) Open Platform(s). 3. 2. 1. 22. EHR offerings such as Practice Fusion Free
2323. and open source software (FOSS) e.g.,
24Open. Disagreement about terminology Mirth , VISTA openEHR NHIN-Direct ONC
Openness not synonymous with Free Open SHARP Grant for Childrens Hospital Boston
source open not same as "good"; and Harvard Medical School Application
closed not "bad" Will WG vendors WG platforms (...migration toward
platforms be innovative? Some. Acknowledge openness). 34.
-- Many benefits of closed system Control 35III. Implications for the Healthcare
over user experience Security, privacy Unbound Community. 35.
But, best case scenario is competition 36Value Creation vs. Value Capture
between WG and Open EHR platforms Many Platform or App? 36.
misc examples of platform control, e.g., 37What’s the disruptive opportunity in
iPhone battery not user replaceable an open EHR technology platform? Value
Proprietary 30 PIN cable vs. USB Customer creation/capture battle between platforms
POV of interoperability, modularity, & apps Platform owners (e.g., Apple
plug-and-play: "It just works" iPhone) want to capture the value by
24. maintaining tight control over their
25A taxonomy of “open” (one example). 1) platforms Application vendors are
Open source – and especially it’s impact incentivized to commoditize the platform
on devices – Android 2) Open standards – so that value creation and value capture
W3C standards 3) Open APIs i.e. can migrate to the applications
Application Programming Interfaces – for themselves. 37.
instance access to Location APIs 4) Open 381) Yesterday: HU Companies (Apps with
access (freedom to contact anyone on the no platform). 38.
network), 5) Open choice of enablers (for 392) Today: Walled Garden EHR
example – the ability to choose your Platform/Apps. 39. Platform A. Size =
billing system), 6) Data portability Value capture opportunity.
(ownership of your data) 7) The ability to 403) Tomorrow: Open EHR Technology
access any application (i.e. not just the Platform/Apps. 40. Platform A. Size =
provider’s application) a.k.a the classic Value capture opportunity.
‘Walled Garden’ debate – On deck/ Off deck 41Beneficiaries of Open EHR Technology
‘Open’ in relationship to the Cloud 9) Platform(s). Patients Doctors &
Impact on developers and a shift in value hospitals: competition, lower prices, no
to the edge of the network 10) Low lock-in Payers Government Commercial
barriers of entry for third party Employers 1000s of app vendors Other care
developers. 25. providers. 41.
26Maximizing vs. Optimizing Openness? 42The Value of the Clinical Groupware
26. Collaborative.
272) TODAY: “Walled Garden” EHR http://clinicalgroupwarecollaborative.org.
Platforms. AMA/Dell AMA to team with Dell 42.
for EHR info platform 3/10 AT&T 43Stages 2 & 3 of HITECH “Meaningful
AT&T Expands Healthcare Community Use” will be a bonanza for the HU
Online to Improve Patient Care 2/10 community. 43.
Axolotl Axolotl Corp Showcases New SOA 44A Thousand Flowers of Innovation In
Technology at HIMSS 2010 3/10 Covisint Full Blossom. 44.
Covisint Jumps onto PaaS Bandwagon 11/09 45END. 45.
A Manifesto for Healthcares Disruptive Innovation of the Decade: Open EHR Technology Platform(s) and Ecosystem.ppt
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