“Will virtual care platforms (VCPs) become healthcare’s mega-platforms?” We believe the potential for such a scenario is strong. We describe and assess parallels between the evolution of the duopoly smartphone operating system (OS) market and the emerging virtual care platform market. We discuss possible implications for VCPs, care providers, health plans, investors and others.

1. Telehealth/Virtual Care
Platform Strategies for
Stakeholders
May 2021
Seth Joseph
Summit Health
seth@summithealth.io
@sethbjoseph
Vince Kuraitis
Better Health Technologies, LLC
vincek@bhtinfo.com
@VinceKuraitis

2. 2
What do all these have in common?
• address books
• video cameras
• pagers
• wristwatches
• maps
• books
• travel
• games
• flashlights
• home telephones
• cash registers
• MP3 players
• day timers
• alarm clocks
• answering machines
• The Yellow Pages
• wallets
• keys
• transistor radios
• personal digital assistants
• dashboard navigation systems
• newspapers and magazines
• directory assistance
• travel and insurance agents
• restaurant guides
• pocket calculators
All disrupted by
smartphone/OS platforms!

3. 3
What do all these have in common?
• Primary care
– Urgent care
– Office visits
• Hospitals
– Inpatient
– Outpatient
– ER
• Specialist access
• Behavioral health
• Diagnostics
• Patient portals
• Home health services
• Medication administration
• Preventive care
• mHealth apps
• EHR functionality/apps, e.g.,
– Scheduling & check in
– Billing
– eRX
– Medication management
– Referral management
– Care planning
– Care coordination
– Social care
– Patient education
– Patient communications
– …many others
All (potentially) disrupted
by virtual care platforms!

4. Agenda
I. Intro & Framing
II. Will Virtual Care Platforms (VCPs) Become
Healthcare’s Mega-Platforms?
Q & A Session
III. Implications of VCP Growth & Consolidation
– Across stakeholders
– Virtual care platform companies
– Providers
– Health plans
– Investors and others
Q & A Session
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5. 5
I. Intro & Framing

6. Healthcare has much to learn about
platform business models & strategy.

7. A Map of the Virtual Health Ecosystem
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TripleTree, A New
Era of Virtual
Health, 2021

8. Surescripts: The First Healthcare Platform
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9. Surescripts: A Story of Network Effects
and Demand Side Economies of Scale
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Network effects!
2006 to 2019: New Adopters
Pharmacy +10,000 +10,000 +10,000 +10,000 +10,000 +10,000
Prescriber +10 +5,000 +9,000 +24,000 +375,000 +500,000
Source: Surescripts’ National Progress Reports, Summit Health Analysis

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II. Will Virtual Care
Platforms (VCPs) Become
Healthcare’s
Mega-Platforms?
(See our detailed article in the Resource Center
or in The Health Care Blog, May 14)

11. Digital Platforms Can Reshape Industries:
Android + iOS = 99% Market Share
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12. Industry Characteristics Producing
Winner-Take-All (or most) Markets:
Comparing Smartphone OSs and VCPs
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INDUSTRY
CHARACTERISTIC
SMARTPHONE
OPERATING SYSTEMS
VIRTUAL CARE
PLATFORMS (VCPs)
Tendency toward single
homing (users prefer one
platform)?
Very High
Patients: Moderate/High
Clinicians: High
Existence of network
effects? Strength?
Yes, Very High Yes, High
High switching costs? Very High Moderate/High
Demand for differentiated
platform functionality?
Moderate TBD
The BIG IDEA: Many similarities between
duopoly smartphone OS and VCP markets!

13. Takeaways
• Yes – potential for VCPs to become healthcare
mega-platforms!
• Winner-take-all (or most)?
– Monopoly or duopoly? Unlikely.
– Oligopoly? Very possible.
• Anticipate dramatic consolidation, M&A
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14. 14
Q & A Session #1

15. 15
III. Implications of VCP
Growth & Consolidation

16. The Right Question Is “How Soon”, Not
“If Or When”
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17. Across Stakeholders
• A virtual care landgrab
• McKinsey study suggests 20% to 30% of care can be
“virtualized”
• Primary care an area of focus and tension
• Importance of platform business strategy
• Unknowns
– Primacy of EHR versus telehealth and resulting
“platformization” priorities
– Regulatory environment post-pandemic
– Many, many others!
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18. Virtual Care Platforms: Land Grab
Opportunity
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• Early mover advantage for broadening capabilities
and leveraging network effects
• Importance of platform vs pipeline thinking
• Investment and market opportunity around
condition and specific population focus
• E.g., Tia, FOLX, Livongo, Ginger
• Opportunity to “envelop” EHRs and EHR
capabilities

19. Local Providers: Period of Stress
• Understand emerging market dynamics
• Virtual care is now table stakes
• Potential new competitors or collaborators
• Learn to work with (and outside) telehealth
platforms1
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1 Hagiu, H, Wright, J. Don’t Let Platforms Commoditize Your Business. Harvard Business Review, May/June 2021

20. Health Plans: Importance of Digital Front
Door
• Mindset shifts
– From telehealth concerns to telehealth potential
– From actuarial and administrative to provision of care
• Technology/platform-first approach to rethinking
strategy
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21. Investors and Others
• How long is the window of opportunity open?
• Many VCPs employing different business strategy
and market approaches
• If employing a true platform approach, pay attention
to how you build the network
• Winner take all implications
• Platform investing requires different skillset and key
metrics than pure technology investing
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22. 22
Q & A Session #2

23. Your Speakers
• Vince Kuraitis, JD/MBA (@VinceKuraitis) is an
independent consultant with over 30 years’
experience across 150+ healthcare & tech companies.
He has deep expertise in platform business models
and strategy. Vince blogs at e-CareManagement.com.
• Seth Joseph is Managing Director of Summit
Health, LLC, a boutique management consulting and
strategy firm specializing in platform business
strategy in healthcare. Seth is also a contributor to
Forbes.com, writing about the intersection of health,
technology and policy.
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