Can EHRs Broaden to Turn into Well being Techniques’ “Platform of Platforms” (UDHPs)? – The Well being Care Weblog

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

Right here’s a top level view of as we speak’s weblog put up:

• A Transient Recap: What are UDHPs?
• Thesis: EHRs Can Broaden to Turn into UDHPs
  1. EHRs At present Personal the Buyer Relationship
  2. Many Prospects Have an “EHR-First” Desire for New Functions
  3. Epic and Oracle Well being are Making Sturdy Actions Towards Turning into UDHPs
• Antithesis: EHRs Can NOT Turn into Efficient EHRs
  1. EHRs Carry a Lot of Baggage
  2. Prospects are Skeptical
  3. EHR Analytics Are NOT Optimized To Obtain Crucial 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 Turn into A Broad-Primarily based Platform
• Synthesis and Conclusion

It is a lengthy put up…over 4,000 phrases…so we’ve clearly bought lots to say on the matter. Hope you introduced snacks!

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

In our earlier in depth put up 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 report (EHR).

The DHP Reference Structure is illustrated in a weblog put up by Higher. Notice that UDHPs are visually depicted as “sitting on high” of EHRs and different siloed sources of well being information:

We famous that nearly any kind of huge healthcare group — well being programs, well being plans, pharma corporations, medical machine corporations, and so on. — had a necessity for UDHPs. Nevertheless, as we speak’s focus is extra slim — we restrict the dialogue to UDHPs in hospitals and well being programs, primarily within the U.S. We use the time period “well being system” to embody hospitals and regional well being supply programs.

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

Within the remaining sections, we’ll lay out arguments on either side of the difficulty of whether or not EHRs can (or can not) broaden to turn out to be UDHPs. The graphic beneath is our crack at a visible abstract. The balloons symbolize the thesis – that EHRs can broaden to turn out to be UDHPs; the anchors symbolize the antithesis – that EHRs can’t broaden to turn out to be UDHPs.

Thesis: EHRs Can Broaden To Turning into UDHPs

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

1) EHRs At present Personal the Buyer Relationship

Fueled by federal HITECH incentives and mandates, well being programs have made vital investments of their present EHRs:

• As of 2021, 96% of non-federal acute care hospitals within the U.S. had adopted a licensed EHR.
• They made enormous capital commitments to buy and set up their EHR, typically a whole lot of thousands and thousands of {dollars}.
• Many present scientific workflows are constructed on EHRs.
• A majority of a affected person’s scientific information in a well being system resides inside their EHR.

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

Thus, any new vendor trying 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 take into account you?”

2) Many Prospects Have an “EHR-First” Desire for New Functions

Well being programs have been attempting to remain afloat in a veritable tsunami of level options. 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 considerations

As proven within the graphic beneath, a 2024 Bain & Firm/KLAS survey of well being programs discovered that 81% more and more plan to look to present 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 spanking new options earlier than trying to others.

College Hospitals is an instance of a well being system with an EHR-First technique. In accordance with Robert Eardley, CIO, this tenet ensures the well being system prioritizes instruments and improvements accessible inside its Epic digital well being report platform each time possible.

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

Maybe the very best argument that EHRs are able to changing 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 Enlargement Plans

Epic is greater than a primary EHR — it gives present 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 in depth record of “Epic Modules.”

In an insightful 2024 evaluation of Epic’s dominant market place, Seth Joseph included an inventory of Merchandise You Can Change with Epic. The record included over 150 capabilities “that will help you determine areas the place you possibly can use your Epic software program to both substitute or keep away from buying area of interest purposes…”

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

Well being Grid — software program offered to

• Labs
• Medical machine corporations
• Payers
• Telehealth corporations
• Medical trials

Well being Grid Adjoining choices

• Cosmos — “an enormous scientific dataset created by pooling info from Epic well being programs”
• Payer Gateway — a “lighter-weight service for payers that permits them to obtain scientific information from Epic healthcare organizations”
• Chart Gateway — “Epic’s service that streamlines how life insurance coverage corporations get medical data 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 introduced extra AI capabilities within the works and that it’s growing 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 standard EHR system, however is it sufficient to satisfy the UDHP wants of contemporary well being programs?

Oracle Well being Goes Past Being a Conventional EHR

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

1. Embedded Synthetic Intelligence (AI): In contrast to EHRs the place AI is usually a bolt-on, Oracle’s new system is designed with AI as a core part, built-in throughout your entire scientific workflow. This features a Medical AI Agent, AI-driven insights on the level of care, AI-powered summaries, and personalised 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 Information Intelligence is an AI and analytics answer embedded throughout the EHR, enabling integration of disparate information sources, real-time insights, and inhabitants well being administration instruments.
4. Subsequent-Era Oracle Cloud Infrastructure gives benefits of enhanced safety, scalability, and efficiency, and higher information trade.
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 info.
6. Concentrate on Worth-Primarily based Care: The system is designed to assist value-based care fashions by streamlining info trade between payers and suppliers, bettering care coordination, and offering insights into price and useful resource allocation.

Oracle Well being goals to maneuver past being a system of report to changing 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 up-to-date announcement of a platform partnership with Cleveland Clinic and G42 is in step with the migration towards changing into a UDHP.

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

Antithesis: EHRs Can NOT Turn into Efficient UDHPs

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

1) EHRs Carry a Lot of Baggage

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

However what concerning the excessive satisfaction scores beforehand cited? EHRs usually tend to take into account well being system directors as their “prospects.” As famous above, clinician “person” 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 usually-used colloquial phrase is that there are “50 dialects of Epic.” Whereas a point of EHR customization is critical and may improve clinician buy-in, over-customization can lead to problem interoperating, as information definitions and workflows can differ enormously. With every EHR occasion doubtlessly distinctive, extending EHRs to turn out to be UDHPs carries ahead organization-specific configurations which can end in substantial longitudinal upkeep (for both the well being system or the companions linked to the EHR).

Lastly, Epic’s distinctive dimension and dominant market place may entice antitrust challenges from authorities regulators. Even as we speak, as Seth Joseph paperwork, 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, doubtlessly garnering extra regulatory oversight.

2) Prospects are Skeptical

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

C-Suites are at a know-how crossroads: Only a few are glad 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 past three years, telehealth and in-home hospital instruments usually are not nicely built-in with EMRs.

When requested “How nicely does your present vendor reside as much as the guarantees it makes concerning the EMR, solely 26% responded “extraordinarily nicely” or “very nicely.”

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 Crucial Well being System Targets

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

A number of EHR Distributors. Each within the U.S. and overseas, bigger well being programs typically are Frankenstein’s monsters stitched collectively from varied acquisitions. Thus, they continuously sport a patchwork of competing EHRs. A HIMSS Analytics research 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 Information. Affected person information in well being programs is unfold throughout a number of programs, not simply EHRs.

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

Affected person Well being and Care Information is More and more Exterior of EHRs. A McKinsey research examined how a lifetime of affected person well being and care information is prone to be created (see the graphic beneath).

By including the numbers in the proper column, you’ll see that an individual generates an estimated whole of 1,106.4 terabytes of well being information over the course of a lifetime. Nevertheless, solely 0.4 terabytes — or 0.04% — is scientific information, i.e., prone to reside in as we speak’s EHRs.

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

We’ve famous that the roots of EHRs are as programs of report to doc processes for fee-for-service billing, nevertheless it 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, somewhat than the worth of affected person outcomes and effectivity.

The restricted interoperability inherent in lots of early EHR programs fostered information silos. This fragmentation made it troublesome to realize the great, 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 programs.

In flip, conventional EHRs sometimes lacked entry to longitudinal claims information and the subtle analytics essential to robustly measure prices and affected person outcomes. In addition they continuously lacked standardized mechanisms for capturing patient-reported outcomes (PROs) and didn’t streamline scientific workflows to particularly assist value-focused care supply. Because of this, these programs weren’t inherently designed to optimize for the ideas and various fee fashions of VBC.

Whereas EHR know-how has superior, these foundational limitations proceed to current vital hurdles for well being programs navigating the complicated transition in direction of VBC and inhabitants well being. Addressing these inherent design constraints is essential for realizing the total potential of digital well being in a future-proofed, value-driven healthcare panorama.

4) EHR Switching Prices are Diminishing

Up to now, switching EHRs was akin to shifting 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.

Nevertheless, authorities coverage, laws, and regulation over the previous 20 years have promoted interoperability and applicable trade of affected person information. 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 information turns into extra fluid and readily shareable throughout completely different programs, switching prices are diminished. That is much more pronounced exterior the U.S., the place requirements like openEHR – a standardized scientific information mannequin which separates information from purposes – are gaining traction, demonstrating the potential of knowledge standardization to ease system transitions. The EU Information Act mandates the flexibility to modify information suppliers seamlessly.

Moreover, the evolution in direction of a UDHP doesn’t essentially require an entire and fast EHR alternative. As we mentioned in a earlier weblog put up, UDHPs could be architected to combine with and leverage present information 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 programs of report to doc fee-for-service billing processes, changing on-site processes with (sometimes) on-prem software program. UDHPs, however, are sometimes 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 high precedence,” this begs the query: the place ought to this software rationalization and optimization happen?

Cloud native software program is a powerful contender, providing most of the CIO-sought advantages and the flexibility to scale in a cost-transparent means. Neil’s latest piece “Head within the Cloud: Right now’s Healthcare Government” 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 aren’t 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 total advantages of cloud-first platforms usually are not achieved by migrating legacy software program.

To get the total advantages of a cloud-first strategy, there’ll should be a re-architecture of programs. It is a giant job, however we have now most of the items as we speak, with scalable databases, Grasp-Information-Administration merchandise, EMPI merchandise, and headless EHRs (ONC Licensed EHRs of report that allow prospects to reskin the affected person and provider-facing experiences). Some main organizations are already creating cloud-hosted centralized information platforms that create a single supply of reality, brokering information throughout their technical ecosystem. Beneath, 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 circumstances, purposes, 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 satisfy 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 keen to combine with anybody, host and provision something wherever, and supply centralized, distributed accessible, – and likewise open – programs. AWS and Azure, for instance, would fortunately host your Epic occasion, hook up with your athenaHealth tablespace, and your level options. Please, proceed including extra!

And, they’ve probably the most superior, scalable databases and information platforms to accommodate that information. This makes the following era 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 Information Platforms for Suppliers Vendor Evaluation, introducing multi-cloud implementations as a potential 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 present and rising programs within the healthcare ecosystem. Multicloud adaptability shall be important to attaining this.“

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

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

EHRs are set of their methods – kinda like your uncle who nonetheless makes use of a flip telephone. In contrast to a lot of as we speak’s most profitable tech corporations, EHRs usually are not “platform native.” We record some potential methods this might inhibit an EHR’s enlargement towards changing into a UDHP:

“Software program Pondering” vs. “Platform Pondering.” To really perceive the transformative potential of Unified Digital Well being Platforms, it’s essential to tell apart between conventional “software program considering” and extra expansive “platform considering.” By their very definition, UDHPs aren’t merely new software program; they symbolize a elementary shift in direction of a platform enterprise mannequin, full with a new algorithm requiring a distinct mindset for achievement.

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 elementary change in how these programs are conceived, constructed, and operated.

Enlargement By In-Home Growth vs. Enlargement By M&A. Traditionally, Epic has largely favored enlargement by way of in-house improvement somewhat 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 acknowledged 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 a whole lot 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 normal EHR mannequin was operated below the belief that exterior builders weren’t really crucial, 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 seen as unresponsive by many app builders. We additionally keep 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 one other weblog put up, 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 Broaden To Turning into UDHPs
• Antithesis: EHRs Can’t Turn into 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 out to be UDHPs. The truth, as at all times, is messier than a binary selection. It’s not ‘EHRs will completely turn out to be 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 earlier weblog put up 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 could 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 choices, relying on quite a few elements comparable to:

• Measurement and sources. Bigger well being programs doubtless will see larger wants for a UDHP; smaller programs extra doubtless 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 extensive 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 growing 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 instructed that this quantity would shrink drastically.

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

Vince Kuraitis JD/MBA is an impartial marketing consultant with over 35 years’ expertise throughout 150+ healthcare & tech corporations.   Neil Jennings is Vice President, Consulting at Untangle Well being. Vince publishes The Healthcare Platform Weblog, the place this put up first appeared. The authors need to thank a number of colleagues for his or her overview and commentary on an earlier draft of this put up: Michael Byczkowski, World 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.