By: Dexter Braff

If you had to choose just one central theme driving health care economic policy today (besides the on again, off again, thumbs up, thumbs down, PushMePullYou of the Affordable Care Act), it would probably be risk management and coordinated care.

And good thing because risk management and coordinated care has given birth to more digital health start-ups than a thousand octomoms.

So many of the solutions we see today are, in one way or another, designed to link patients, physicians, hospitals, pharma, and of course, payors to deliver the right care, to the right patient, in the right setting, at the right time.

The thing is, try as one might, you probably have a better chance channel surfing past The Shawshank Redemption without stopping than developing anything near an all-encompassing platform to manage risk and coordinate care up, down, and across the health care continuum.  With enough diversity of health care needs, physician specialties, treatment options, settings, mission-critical data (that feed predictive analytics), and billing requirements to make a college admissions officer swoon, forget being all things to all people.  How about just one thing for one people?

So, we do see end-to-end (or nearly so) solutions; however, for extremely specific populations – HIV/Aids, diabetes, obesity, congestive heart failure, complex pediatrics (to name a few).  Because from a practical perspective, to be truly successful in digital health applications, the decision trees can’t be a forest.

And therein lies the problem.

It’s one thing to connect all the dots in a sub, sub, subsegment of the population.  It’s quite another to risk manage and care coordinate an entire population with care needs that are not-so-conveniently compartmentalized and precise.

And therein lies the problem, part deux.

If you’re the CMO or CIO of a large hospital system, physician group, insurance company, employer, managed care organization, or convener, you’ve got to evaluate, beta test, implement, and secure perhaps dozens of solutions.  And somehow create interfaces among them all so that you can risk manage and care coordinate a person versus a disease or condition.

So digital health entrepreneurs must convince their customers to add yet another application to a burgeoning assemblage of solutions that, each installation later, becomes that much more difficult to manage.

And that’s a PushMePullYou of another color.

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