Healthcare providers are adapting in response to technologies enabling remote work, staffing shortages, patient preferences, and the competitive landscape of inpatient care. One of the current trends is that of hospitals shifting to or implementing complimentary “hospital at home” models for patient care, with some predicting that 40% of providers will shift 20% of hospital beds to the home over the next three years. Primary care and home health providers are using remote monitoring and non-face-to-face communication (as payer arrangements allow) to keep patients comfortable in their homes. And payers are adapting to allow for care at home reimbursement that uses innovative healthcare solutions. What’s missing are platforms for connecting those in need with core and non-care services.
Traditional hospitals and providers are focused on services. They have the infrastructure to provide and support care. When patients move into the home, technology becomes a critical component for communication, collaboration, and care. Technology helps providers communicate with each other and aggregate support that the patient may need, making it easier for patients or their caregivers to access resources that were previously limited to traditional healthcare settings. Without technology, much of the burden to aggregate support for the patient is placed on the caregiver. This often leaves the caregiver lost and confused as they often lack the resources necessary to make informed decisions. For care at home to be truly effective, additional services, such as those that address social determinants of health, need to be made available, as they have been found to contribute up to 80% of a patient’s health outcomes.
For healthcare at home to be successful, a tech-first platform approach is required. This approach involves aggregating suppliers (healthcare providers and resources), patients, and caregivers, and then successfully matching patient needs with the right suppliers of care and innovative healthcare solutions. While healthcare providers have historically been the locus of care deliver, a unique component to healthcare at home is the inclusion of suppliers which serve non-health needs along the social determinants of health, such as transportation and food delivery.
A platform approach is not unique to healthcare at home. Platforms connecting consumers and suppliers, such as Uber and Airbnb have been widely adopted across international markets with great success. These platforms specialize in connecting suppliers and consumers to create network effects, where the value of the platform increases as the number of users on either side of the network increases.
It is not surprising that platforms in healthcare have seen increased attention in recent years. Many policies, investments, and companies are supporting the creation of technologies in the healthcare at home space. Some estimate that investments in digital health platforms in 2021 ($11.8B) alone have outpaced all digital health investments in 2019 ($8B), and are currently receiving almost six times more funding than their non-platform counterparts.
Despite the resounding interest and investment, platforms in healthcare have not had the same widespread success seen by Uber and Airbnb, and often have a high failure rate just a few years after their launch. This is likely due to a variety of factors, including:
- Failure to gain traction with clients where sales cycles are lengthy and users are not ready to adopt new technologies
- Pricing models that are not aligned with stakeholder value and/or do not align payment with the outcomes delivered
- The high cost of developing platforms robust enough to realize network effects that self-propel in the marketplace
- The varying complexity of healthcare organizations limits “one size fits all” approaches
- Emphasis on developing only one side of the network
Looking across successful non-healthcare platforms, we have identified components that investors, start-ups, and policymakers should consider when supporting healthcare at home by aggregating through platforms.
- Patient Acquisition Capabilities
Not only must patients be attracted to the platform through marketing efforts, but the platform must also be effective in providing value to newly acquired patients for ongoing retention. An example of providing value is effective needs identification, and the ability to pair patients with high-quality providers or resources in a timely manner to solve those needs.
- Supplier and Provider Aggregation
To successfully attract suppliers and providers, platforms must be more effective at quality patient acquisition than traditional means. In addition, aligning with priorities, maintaining trust, and ensuring sustainable revenue will keep suppliers and providers engaged in the platform.
- Financing
The most successful platforms launched have been those that have put aggregating a network ahead of creating a profit. Platform research shows that it often takes 5-7 years of platform development to achieve the level of aggregation necessary to develop a self-sustaining network effect. This financing may come in the form of upfront investment in the platform and may sustain through innovative reimbursement and investment strategies.
- Technology
Technology should be built to support the ease of pairing patients with suppliers and providers. This includes supporting care coordination, developing simple self-scheduling platforms, and ensuring ease of provider use. The easier a platform is to use, the more effective it will be at delivering the value necessary to propel a network effect.
To be successful in healthcare at home, all the suppliers and providers that promote a patient’s health must be aggregated and organized such that the most effective and innovative solutions to their healthcare needs are in plain sight. This suggests platform approaches may achieve success by building network effects through a critical mass on both the supplier and patient sides. While healthcare has not been effective at building platforms just yet, we encourage organizations tackling healthcare at home to learn from other platforms outside of healthcare, and apply the components above to create platforms that aggregate suppliers and patients and effectively serve both sides of the network.