U.K. clinicians knew that patients could benefit from remote kidney function monitoring at home and that these devices were being developed, but it was unclear how to best design one with patient needs in mind.
That is where Thiscovery came in. The University of Cambridge spin-out, which is backed financially by not-for-profit companies, uses a platform business model to connect innovators, device manufacturers, patients and clinicians on a platform network to crowdsource design ideas.
“We are changing the way healthcare is delivered to end-users by using the platform model as a kind of conceptional model as well as a business model,” says Ruth Cousens, Thiscovery CEO and Co-founder Ruth Cousens.
The platform runs online projects which gather the knowledge and experience of people who use, deliver and influence health and care services. Insights gathered allow its clients to solve real problems by shaping innovative evidence-based solutions. For example, it was used to work with maternity staff and families across England to develop new approaches for identifying and managing situations where babies are experiencing difficulties during labor. “This is being piloted and we hope will eventually be rolled out across the UK,” says Cousens, who will be a speaker at the Platform Leaders Conference in London on November 13. “There is a huge potential for platform models to influence public health policy and the delivery of health services,” she says.
Around the world, healthcare has struggled with uneven access and quality for decades. To try and change that dynamic healthcare professionals, such as the President and CEO of the world-renowned Mayo Clinic, have publicly urged a move from traditional, linear pipeline-service-model thinking to a platform approach that fundamentally changes how healthcare and advance cures are provided.
Andreessen Horowitz, a top-tier Silicon Valley venture capital firm, supports the shift. “We strongly believe there is a trillion dollar opportunity in becoming the front door to healthcare—the marketplace where consumers go to find and book appointments across multiple conditions and specialties, buy the lowest cost drugs, and even shop for insurance,” the VC firm wrote in an article published last year entitled “Healthcare Marketplaces Where Art Thou?”
The need is there. “There is a big gap between consumer expectations and what health care systems offer today,” says Laure Claire Reillier, Co-founder and CEO of Launchworks & Co, the organizer of the Platform Leaders conference. “They are used to choice, convenience and speed when they book a taxi, or a holiday and the platform economy plays a huge part in that. If you compare that with healthcare services, it is like day and night.”
Healthcare systems are huge, run in silos, are fragmented and full of inefficiencies and complexities. “It is really hard to navigate these systems,” she says. “Platforms can bring a lot of value in terms of coordination and better use of resources at scale by bridging the gap where there are pockets of unmet demand.”
For example, Florence, a U.K. marketplace that will participate in a panel at the Platform Leaders conference, matches nurses with healthcare providers that need them, says Reillier. “There are so many gaps and unmet needs.”
Helping Mental Health Patients
In the U.S. mental healthcare platforms are one of the first successful use cases of healthcare platforms, according to Andreessen Horowitz. The VC firm cites U.S. platforms Headway, Alma, Sondermind, and Path as examples. All four are platforms which are helping mental health professionals take insurance and connect them to consumers who need their services.
Most mental health providers historically have not accepted insurance. They’re often solo practitioners who don’t have the bandwidth to contract with each insurance company, and basic insurance contracts pay less than the provider could make by charging consumers directly. New mental health marketplace companies propose to handle the complex logistics around insurance contracting and billing and negotiate better payment rates than providers could get on their own, notes Andreessen Horowitz. On the backend, these marketplaces are structured as MSOs (Managed Service Organizations) that deal with the logistics of insurance and other backoffice support services.
In mental health, the drivers of successful growth have been:
- Very high consumer demand driven by increased incidence of mental health issues and the cultural destigmatization of therapy
- Widespread adoption of telehealth, propelled by both necessity during the pandemic, and favorable regulatory changes
- A historical dearth of therapists who take insurance, which has resulted in…
- …insurance companies that are desperate to expand their mental health provider networks, and are therefore willing to pay competitive rates to platforms that can expand their network coverage
The key element that makes these marketplaces work is the fact that they offer deep supply-side services that benefit both the provider (by diversifying their revenue stream beyond cash pay clients) and consumer (reduces out-of-pocket costs per appointment), according to the venture capital firm.
U.S.-based Resilience Lab, which is using a platform business model to deliver mental health care at scale, is doing just that and more. It has developed its own methodology to train and certify therapists, to manage the quality of the care and ensure quality across all its certified providers. Then, it connects clients with mental health issues to the certified clinicians. Like other companies in the space the platform makes treatment assessable and affordable through insurance partnerships. But now Resilience Lab is taking its offer one step further. On October 8 the U.S. company announced the acquisition of Options MD, a leader in online psychiatric medication management for severe and treatment-resistant depression, a serious and often overlooked mental health condition that contributes to high costs of care and high level of patient disability.
The acquisition means that Resilience Lab can now offer integrated medication management and psychotherapy for moderate to severe mental illness, including mood and anxiety disorder, post-traumatic stress disorder (PTSD), and attention deficit hyperactivity disorder (ADHD).
Resilience Lab has also gained Option MD’s clinical intake and AI decision support platform which offers intelligent differential diagnosis and treatment recommendations that aim to improve diagnosis and help clinicians create the most effective care plan, according to the company. Clients of Resilient Lab who suffer from moderate to severe mental illness can now undergo an assessment and be referred to a specialized clinician for medication management, while Options MD Clients can complement their treatment with a qualified therapist to accelerate their mental health recovery.
“Primary care physicians do not know how to deal with these patients,” says Resilience Lab CEO Marc Goldberg. “The problem is systemic as primary care providers usually prescribe antidepressants after five minutes of a patient interview and do not have the time, training and incentive to provide care for any mental health issue,” he says. His company is operational in five U.S. states and works with 12 insurance companies that together cover 24 million people. The next step is to expand the platform to include corporates and their employees, says Goldberg.
Using Platforms To Mind The Gaps In the U.K.’s Healthcare System
In the U.K. the National Health Service is overwhelmed. Lengthening NHS waiting lists, which hit a peak of nearly 7.8 million in England in September, have prompted more people to take out private medical insurance in recent years, despite its rising cost, dipping into savings or taking out loans to pay for routine operations, often spending thousands of pounds. Many are not sure which clinician or hospital to turn to.
That is where MeditSimple, a UK healthcare marketplace, comes in. On October 28, the platform, which was launched in 2019, announced MeditSimpleAI, an AI tool providing what the company says is “responsible, personalized” healthcare guidance to patients who find it increasingly difficult to access timely and effective care.
“MedSimpleAI helps lower the pressure on healthcare systems without compromising quality,” says Laurence Lévy, MeditSimple’s CEO. “According to the OECD 20% of healthcare costs are wasted on unnecessary tests and consultations,” she says. “We can reduce this to 5%.”
It works like this: patients enter their symptoms in MeditSimpleAI, and the platform will identify related symptoms, medications, and medical conditions that may impact their current state. Based on this assessment MeditSimpleAI provides a ranked list of the best care options, complete with clear, actionable explanations, the company says. It also flags any symptoms to monitor that might indicate a need for urgent care.
MeditSimpleAI offers recommendations based solely on medical relevance and patient preferences—free from ads or affiliations, says Lévy.
“Most of the patients we support are insured and benefit from a streamlined process that ensures they are fully prepared for treatment from an administrative standpoint – something hospitals greatly appreciate,” she says. “Hospitals also value our efforts to make their services more accessible and understandable for patients. Through our integrated search engine patients can easily explore and navigate available services, enabling immediate insurance refunds and significantly enhance both the accessibility and transparency of the care provided.”
The platform has agreements with hospitals, clinics and imaging centers. “Our mission is to make healthcare sustainable and responsible for both patients and healthcare professionals,” says Lévy. “Unlike other marketplaces we don’t encourage consumption of healthcare services but rather promote better, more efficient care while alleviating burdens on medical facilities and professionals.”
Healthcare Needs Its Own Platform Strategy
Earlier this year research published by MIT Sloan Management Review found that best practices that have proven successful for digital platforms in other business contexts are less useful in the context of healthcare. An article entitled “Healthcare Platforms Need a Strategy Overhaul” sheds light on how platform strategy must evolve as it is applied to solve new problems in new markets.
Researchers Marcus Holgersson, Joakim Björkdahl, Anna Essén, and Johan Frishammar identified the unique challenges digital health care platforms face, based on four-year-worth of study. From 2018 through 2022, the authors studied digital health platforms in Sweden, focusing on platform strategy, ecosystem management, and user behavior. They conducted 108 interviews in 14 organizations — four major digital primary care platforms, two platform technology developers, five established public and private health care providers, two health care agencies, and the Swedish Association of Local Authorities and Regions — and with individual users of digital health platforms.
What they found was that due to the special nature of the healthcare sector, network effects don’t work in the same way and that due to regulatory restraints that can differ from country to country and even region to region, it is much more difficult to scale them, Holgersson said in an interview with The Innovator.
In their article the researchers outlined a three-part approach for making health platforms grow and succeed. To avoid costly mistakes, organizations need to shift their mainstream assumptions about platform strategy and make different decisions about key domains to align with a digital health perspective:
- Market Entry — Unlike platforms such as Airbnb and Amazon, healthcare platforms are not a substitute but rather a complement to established services. Digital health platforms should focus on a narrow and well-defined scope and integrate with established ecosystems.
- Scaling the Business — The concept of network effects is central to platform strategy. Having an increased number of users is important for platforms such as Facebook, but for health care platforms, learning from and leveraging data from users will improve adoption and retention. Digital health platforms should use data to develop operational excellence and for business model development.
- Ecosystem Governance — Organizations such as Apple centralize orchestration among their ecosystem of apps and developers, but health care platforms must function under distributed orchestration among physicians, health care organizations, governments, insurance companies, and more. Digital health platforms need to build sociopolitical legitimacy and proactively participate in regulatory development.
“Digital health care platforms, if done right and implemented well, can be a large step in solving the productivity crisis in healthcare,” researcher Frishammar, a professor of entrepreneurship and innovation at Luleå University of Technology in Sweden, was quoted as saying in a press release about the study. “There is still much to be explored in what these platforms can do and should do, but ultimately they can make healthcare more accessible and more affordable.”
“The potential is huge in terms of cost savings and quality improvement,” says Holgersson.
Moving From The Periphery To The Core
The question is whether it will really be possible to transform huge healthcare systems. “I think the answer is yes,” says Launchworks’ Reillier. She cites the example of a platform in the UK called Patients Know Best which, with a patient’s permission, aggregates all their healthcare data from various practitioners in one place, giving them access to their own healthcare data and the power to share it. The service is going to be rolled out across the U.K. It is an example of how platforms can move from the periphery to the core of healthcare, she says.
There is a huge pent-up demand not just for medical care but also for preventative care, says Reillier. Daniel Ek, the founder of music sharing service Spotify, recently opened a business in London called Neko Health that offers people full body scans for 299 British pounds. Within the first month 30,000 people had signed up and there is a waiting list to be seen.
This kind of affordable prevention should be integrated into healthcare services, says Reillier. “We need to avoid a two- speed system where only those that can afford healthcare will have access,” she says. “Platforms can be part of the answer to coordinate participants and help orchestrate the emerging healthcare systems of tomorrow. Since they are smaller and nimble, they can begin by complimenting existing services and eventually transform them.”
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