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

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

• A Temporary Recap: What are UDHPs?
• Thesis: EHRs Can Broaden to Grow to be UDHPs
  1. EHRs At the moment 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 Changing into UDHPs
• Antithesis: EHRs Can NOT Grow to be Efficient EHRs
  1. EHRs Carry a Lot of Baggage
  2. Prospects are Skeptical
  3. EHR Analytics Are NOT Optimized To Obtain Essential 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 Grow to be A Broad-Primarily based Platform
• Synthesis and Conclusion

This can be a lengthy submit…over 4,000 phrases…so we’ve clearly acquired so much to say on the matter. Hope you introduced snacks!

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

In our earlier intensive submit 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, change the dominant period of the monolithic digital well being document (EHR).

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

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

On this submit, we concentrate on 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 are going to lay out arguments on either side of the problem of whether or not EHRs can (or can not) increase to turn out to be UDHPs. The graphic under is our crack at a visible abstract. The balloons characterize the thesis – that EHRs can increase to turn out to be UDHPs; the anchors characterize the antithesis – that EHRs cannot increase to turn out to be UDHPs.

Thesis: EHRs Can Broaden To Changing into UDHPs

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

1) EHRs At the moment Personal the Buyer Relationship

Fueled by federal HITECH incentives and mandates, well being methods 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 big capital commitments to buy and set up their EHR, typically a whole lot of tens of millions of {dollars}.
• Many present scientific workflows are constructed on EHRs.
• A majority of a affected person’s scientific knowledge in a well being system resides inside their EHR.

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

Thus, any new vendor making an attempt 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 contemplate you?”

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

Well being methods 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
• Price and ROI considerations

As proven within the graphic under, a 2024 Bain & Firm/KLAS survey of well being methods 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 new options earlier than seeking to others.

College Hospitals is an instance of a well being system with an EHR-First technique. In keeping with Robert Eardley, CIO, this guideline ensures the well being system prioritizes instruments and improvements out there inside its Epic digital well being document platform every time possible.

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

Maybe one of the best argument that EHRs are able to turning 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 fundamental EHR — it presents 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 gives an intensive listing of “Epic Modules.”

In an insightful 2024 evaluation of Epic’s dominant market place, Seth Joseph included a listing of Merchandise You Can Substitute with Epic. The listing included over 150 capabilities “that will help you establish areas the place you may use your Epic software program to both change 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 gives an in depth listing:

Well being Grid — software program offered to

• Labs
• Medical gadget corporations
• Payers
• Telehealth corporations
• Scientific trials

Well being Grid Adjoining choices

• Cosmos — “an enormous scientific dataset created by pooling info from Epic well being methods”
• Payer Gateway — a “lighter-weight service for payers that allows them to obtain scientific knowledge 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 — companies choices
• Revcyclers — “Third events working with Epic and supply billing companies 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 a giant 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 conventional EHR system, however is it sufficient to satisfy the UDHP wants of contemporary well being methods?

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 conventional EHR. It goals to go considerably past the capabilities of a conventional EHR:

1. Embedded Synthetic Intelligence (AI): Not like EHRs the place AI is usually a bolt-on, Oracle’s new system is designed with AI as a core element, built-in throughout your entire scientific workflow. This features a Scientific 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 resolution embedded inside the EHR, enabling integration of disparate knowledge sources, real-time insights, and inhabitants well being administration instruments.
4. Subsequent-Technology Oracle Cloud Infrastructure presents benefits of enhanced safety, scalability, and efficiency, and higher knowledge alternate.
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 help value-based care fashions by streamlining info alternate between payers and suppliers, enhancing care coordination, and offering insights into value and useful resource allocation.

Oracle Well being goals to maneuver past being a system of document to turning 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 turning into a UDHP.

Oracle Well being continues to be in its early phases of a roll-out, with an early adopter program launched in 2025. Subsequently, intensive, extensively revealed surveys and large-scale buyer suggestions about this new platform aren’t but out there.

Antithesis: EHRs Can NOT Grow to be Efficient UDHPs

Now let’s study arguments suggesting that EHRs aren’t able to turning into well being methods’ “platform of platforms” — a UDHP.

1) EHRs Carry a Lot of Baggage

Right this moment’s EHRs are criticized on a lot of fronts: errors and questions of safety, value, lack of competitors, lack of interoperability, and lack of usability for clinicians.  COVID-19 highlighted lots of the weaknesses in EHRs as being “giant, gradual monoliths that don’t rapidly adapt to new, emergent calls for on their design and workflow.”

However what in regards to the excessive satisfaction scores beforehand cited? EHRs usually tend to contemplate 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 website to a different. The customarily-used colloquial phrase is that there are “50 dialects of Epic.” Whereas some extent of EHR customization is critical and may improve clinician buy-in, over-customization can lead to issue interoperating, as knowledge definitions and workflows can differ vastly. 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 might appeal to 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 methods might need an “EHR-First” integration desire, many are additionally skeptical of their EHR vendor’s guarantees and their potential to combine new apps. Sage Progress Companions report entitled The New Healthcare C-Suite Agenda: 2024-25 addressed the problem:

C-Suites are at a expertise crossroads: Only a few are happy with their EMR vendor, the market is flooded with level options however integrations are irritating workers extra, and regardless of the coverage relaxations round telehealth over the past three years, telehealth and in-home hospital instruments will not be properly built-in with EMRs.

When requested “How properly does your present vendor stay as much as the guarantees it makes in regards to the EMR, solely 26% responded “extraordinarily properly” or “very properly.”

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 Essential Well being System Targets

Any particular person EHR can NOT be considered 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 methods typically are Frankenstein’s monsters stitched collectively from numerous acquisitions. Thus, they steadily sport a patchwork of competing EHRs. A HIMSS Analytics examine discovered that the typical 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 knowledge in well being methods is unfold throughout a number of methods, not simply EHRs.

Affected person and Information “Leakage.” Right this moment’s sufferers are extra motivated by comfort than loyalty to 1 well being system; affected person leakage throughout care suppliers is critical. A examine 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 examine examined how a lifetime of affected person well being and care knowledge is prone to be created (see the graphic under).

By including the numbers in the best column, you’ll see that an individual generates an estimated whole of 1,106.4 terabytes of well being knowledge over the course of a lifetime. Nonetheless, solely 0.4 terabytes — or 0.04% — is scientific knowledge, 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 knowledge. Optimum end-to-end analytical methods for affected person knowledge — ones designed for each prevention and care – might want to pull knowledge 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 methods of document 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 companies and administrative duties. Consequently, their structure emphasised documenting the quantity of care delivered for reimbursement, relatively than the worth of affected person outcomes and effectivity.

The restricted interoperability inherent in lots of early EHR methods fostered knowledge silos. This fragmentation made it tough to realize the excellent, holistic affected person view important for efficient value-based care (VBC) and value-based funds (VBP), care coordination, inhabitants well being administration, whole value of care measurement and administration, and different capabilities wanted for cutting-edge well being methods.

In flip, conventional EHRs usually lacked entry to longitudinal claims knowledge and the subtle analytics essential to robustly measure prices and affected person outcomes. Additionally they steadily lacked standardized mechanisms for capturing patient-reported outcomes (PROs) and didn’t streamline scientific workflows to particularly help value-focused care supply. Because of this, these methods weren’t inherently designed to optimize for the rules and numerous cost fashions of VBC.

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

4) EHR Switching Prices are Diminishing

Previously, switching EHRs was akin to transferring 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.

Nonetheless, authorities coverage, laws, and regulation over the previous 20 years have promoted interoperability and applicable alternate of affected person knowledge. The HITECH Act, the twenty first Century Cures Act, the promotion of HL7 FHIR APIs, and the creation of TEFCA exemplify this development.

As affected person knowledge turns into extra fluid and readily shareable throughout completely different methods, switching prices are diminished. That is much more pronounced exterior the U.S., the place requirements like openEHR – a standardized scientific knowledge mannequin which separates knowledge from purposes – are gaining traction, demonstrating the potential of knowledge standardization to ease system transitions. The EU Information Act mandates the power to change knowledge suppliers seamlessly.

Moreover, the evolution in the direction of a UDHP doesn’t essentially require a whole and instant EHR substitute. As we mentioned in a earlier weblog submit, UDHPs may be architected to combine with and leverage present knowledge repositories, together with EHRs. This incremental method 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 methods of document to doc fee-for-service billing processes, changing on-site processes with (usually) on-prem software program. UDHPs, alternatively, are usually 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 lots of the CIO-sought advantages and the power to scale in a cost-transparent manner. Neil’s current piece “Head within the Cloud: Right this moment’s Healthcare Govt” 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 places can add incremental advantages to efficiency, value of possession, and scalability, the complete advantages of cloud-first platforms will not be achieved by migrating legacy software program.

To get the complete advantages of a cloud-first method, there’ll should be a re-architecture of methods. This can be a giant activity, however now we have lots of the items as we speak, with scalable databases, Grasp-Information-Administration merchandise, EMPI merchandise, and headless EHRs (ONC Licensed EHRs of document that let prospects to reskin the affected person and provider-facing experiences). Some main organizations are already creating cloud-hosted centralized knowledge platforms that create a single supply of reality, brokering knowledge throughout their technical ecosystem. Beneath, we’ll cowl some main advantages of this extra encompassing cloud-first method.

The place EHR distributors have traditionally moved slowly, cloud service suppliers are quickly including shared companies 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 submit, cloud-hosted ERP platforms are additionally rising to the event to satisfy UDHP wants.

Past the listing of advantages above, it’s the method 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 – methods. AWS and Azure, for instance, would fortunately host your Epic occasion, connect with your athenaHealth tablespace, and your level options. Please, proceed including extra!

And, they’ve probably the most superior, scalable databases and knowledge platforms to accommodate that knowledge. This makes the following technology of level options, CDS options, or AI-derived brokers even simpler to create as cloud-first, as the information 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 doable route, stating that “Almost 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 methods 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 capable of accommodate any EHR and are aligning incentives to speed up cloud adoption. If these cloud platforms can handle healthcare’s knowledge complexity, what’s stopping them from being the UDHPs accelerating innovation in healthcare?

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

EHRs are set of their methods – kinda like your uncle who nonetheless makes use of a flip cellphone. Not like a lot of as we speak’s most profitable tech corporations, EHRs will not be “platform native.” We listing some potential methods this might inhibit an EHR’s enlargement towards turning into a UDHP:

“Software program Considering” vs. “Platform Considering.” To really perceive the transformative potential of Unified Digital Well being Platforms, it’s essential to differentiate between conventional “software program pondering” and extra expansive “platform pondering.” By their very definition, UDHPs aren’t merely new software program; they characterize a basic shift in the direction of a platform enterprise mannequin, full with a new algorithm requiring a unique mindset for fulfillment.

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 basic change in how these methods are conceived, constructed, and operated.

Enlargement By way of In-Home Improvement vs. Enlargement By way of M&A. Traditionally, Epic has largely favored enlargement by means of in-house growth relatively than embracing the platform technique of development by means of acquisitions and fostering an exterior ecosystem. Judy Faulkner, the influential founding father of Epic, has famously said Epic won’t ever be offered and has additionally traditionally maintained a stance in opposition to buying different corporations.

This inward focus contrasts sharply with the method 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 method.

Foot-Dragging On Interoperability vs. Interoperability by Default. The early historic method 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 standard EHR mannequin was operated below the idea that exterior builders weren’t actually obligatory, a viewpoint diametrically against the platform enterprise mannequin the place builders are central.

In 2017, Epic opened its app retailer to a gradual begin. Epic was considered 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 way more vibrant developer packages. In but one other weblog submit, 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 Changing into UDHPs
• Antithesis: EHRs Can’t Grow to be Efficient UDHPs

We’ll additionally concede that the wording is a bit deceptive — it implies black/white situations below which EHRs both will or is not going to turn out to be UDHPs. The truth, as all the time, is messier than a binary alternative. 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 submit 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 may be adopted incrementally and over time. UDHPs can accommodate EHRs as elements, and UDHPs and EHRs will not be 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 a lot of elements comparable to:

• Measurement and assets. Bigger well being methods probably will see higher wants for a UDHP; smaller methods extra probably 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 huge ranges of specialties all add complexity, required connections, and extra alternative with a UDHP method.
• Present EHR vendor. Some EHR distributors may succeed at growing UDHP capabilities, others won’t. TBD.
• Pricing of UDHPs vs. EHRs. TBD.
• Evolution of UDHP capabilities and market acceptance. TBD.
• UDHP vendor and market evolution. In our earlier submit, we highlighted over 20 UDHP vendor “candidates”, and later recommended that this quantity would shrink drastically.

In our subsequent submit on this collection, we’ll phase the healthcare supplier market to judge for whom (which hospitals and well being methods) the EHR might function the UDHP and when it is smart to decide on a cloud-first resolution.

Vince Kuraitis JD/MBA is an impartial guide 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 submit first appeared. The authors need to thank a number of colleagues for his or her evaluation and commentary on an earlier draft of this submit: 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.