Platform Do’s and Dont’s (from a former platform failure)
I saw that Truveta raised 200 million. Commure did 500. I don’t know about Graphite, but my sense is that they are pretty well funded too.
Healthcare has needed a platform company for years and pursuit of that goal is a noble one. The level of basic work duplication we all experience every day in healthcare is tragi-comic to a Shakespearean level. The learnings that we don’t get to because the data points to study our hypotheses are far-flung and not interrelated are overwhelming to the point of exhaustion. While there are some economic benefits to these silos among the silo owners, it is nothing compared to the hypothetical benefits available to those same siloists (my word, yer welcome) of data federation. I could go into defining this in detail, but it seems that particular horse has been beaten into cat food by now.
One does encounter corpses on the way up Healthcare Platform Mountain™ though. Here is my fledgling playbook on how to avoid the traps and snares and not become another cadaver on the path up the mountain.
- Start with practical, everyday jobs to do. This is the biggest one and it is the one followed LEAST by the aspiring healthcare platform players I have seen. Facebook didn’t start as a platform. Neither did Amazon, nor “Force”. Stripe DID start as a platform but it was driving such a narrow and specific job to do that it didn’t lose its way. In fact, you can find those full payment workflows for free on the Stripe developer site to copy and use as is. In every case, every successful platform started with a discrete job it knew how to do that guided its development. It gave the servers a regular beating. It made the data operational, not just “born for data-lake” data.
- Find customers who selfishly want to be on a platform from day one…not those who want to want it. Not those who feel that they should want it. I worry that hospital systems — all led by conscientious caring people — want to want a platform to subsume their current Epic/athena/Cerner datastore, but may flinch when it’s time to make operational sacrifices to that end. For example, Hypothetical Hospital may want to get a better bead on soft tissue cancers and may be willing to share what they have on the subject; but would they let go of control of their core medical record? Could they even get that past their compliance committee? Would they trust registration to someone else? Here, I recommend cloud-born digital health companies and NOT established providers as your first customers. Their business models are mostly of the “focused factory variety. Unlike a general hospital, they won’t want to be in a position to do something for everyone. Mostly they want to crush one narrow thing at a national scale. That means they want to share what they learn in other aspects of their patients’ care. They do better when they share regardless of whether they are viewed as politically correct.
- Subscribe to a theory of plenty. Many people are now building many tools for healthcare. Every one of them has distribution/sales as their biggest problem…it’s also the biggest slice of the revenue pie. Because our cost of sale is so high, we aren’t used to the idea of letting anyone besides ourselves into our clients unless they pay us a king’s ransom. This is shortsighted. The right thing is to integrate your platform with as many building tools as possible, even those that are directly competitive. This is not to be nice or good. In fact, it’s greedy, long-term greedy to make it easy for people to use your tools without having to give up others.
Obviously, take this with a grain of salt if you want. I’m mostly no one to give advice on platform building since I got fired partway into unsuccessfully rewiring my last business as a platform. So what are you reading from me for? Maybe history is written by the winners…but we losers have some wicked awesome stories to tell!
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