Many health systems are opting for a single EHR and enterprise resource planning system, relying on foundational enterprise platforms for much of their technology needs.
This also means they’re consolidating and turning off IT applications, depending less on point-solution companies and startups. But does this approach throttle innovation? Not necessarily, CIOs told Becker’s.
“Many forces are driving health systems to consolidate applications and reap the benefits of ‘platformization,’” said Joel Klein, MD, executive vice president and chief digital and information officer of Edison, N.J.-based Hackensack Meridian Health. “They can save money, keep users in their natural workflow, build with highly developed teams, and stick to the core mission if they don’t try to become a software development company.”
However, platforms don’t always meet every need, Dr. Klein said. So, as a “bridge,” a health system may turn to a point solution or build its own application until the platform can absorb or replace it.
“The consequence for the broader industry is clear: the era of the ‘disruptive standalone’ is over,” Dr. Klein said. “For innovation to survive today, it must be ‘platform-compatible.’ We aren’t stifling innovation; we are requiring it to be more disciplined.”
CIOs say that an enterprise platform essentially creates a foundational IT base — preserving governance, safety and scalability — that a point solution would need to integrate with to be effective.
A platform strategy doesn’t shut out innovative startups but, rather, builds a “clearer,
faster path for them to land and expand in a health system,” said Lisa Stump, executive vice president and chief digital information officer of New York City-based Mount Sinai Health System.
“Without a platform, health systems are forced to repeat an intake process — security review, contract negotiation, integration — for every new point solution,” she said. “Likewise, every entrepreneur is forced to rebuild the same basics at every customer — integration, authentication, security reviews, data access patterns, monitoring, and workflow fit — which slows adoption and turns pilots into one-off projects.”
Health systems also often elevate platform providers to the level of “partner,” a status that entails jointly developing roadmaps for software needs.
“Enterprise platforms such as Epic, Microsoft and Workday exist for good reason,” said Terri Couts, RN, senior vice president and chief information and digital officer of San Diego-based Sharp HealthCare. “They drive interoperability, reduce risk, support regulatory compliance, and create consistency at scale. But left unchecked, the gravitational pull toward standardization can quietly crowd out the nimble, purpose-built solutions that often deliver the most meaningful clinical and operational breakthroughs.”
At the same time, Sharp HealthCare is streamlining its application portfolio by asking whether solutions deliver value, eliminate redundancies, and align with the health system’s strategy and path forward. This strategy also aims to reduce complexity, which Ms. Couts calls the “quiet killer of innovation in health IT.”
“The leaders who get this right treat their enterprise platform as a foundation, not a ceiling,” she said. “They rationalize the portfolio ruthlessly, invest in integration infrastructure like APIs and interoperability layers, and build governance models that create a clear, fair pathway for innovative solutions to prove their value without bypassing the security, privacy, and clinical safety standards that protect our patients and our people.”
Health system CIOs then must continue to find the right balance between enterprise consistency and creativity.
“When the platform itself is expected to be the sole source of innovation, it can limit the ability to adopt targeted, best-of-breed solutions that address specific business problems,” said Sarah Hatchett, senior vice president and CIO of Cleveland Clinic. “Our approach has been to treat platforms as the foundation — leveraging them where they add value — while also creating repeatable architecture patterns that allow us to plug in point solutions as needed, preserving flexibility and supporting innovation as a core value of Cleveland Clinic.”
Enterprise platforms remain crucial for “patient experience, workflow efficiency and scaling,” said Kristin Myers, executive vice president and chief digital officer of New Hyde Park, N.Y.-based Northwell Health.
“Increasingly, EHR platforms like Epic Systems are also embedding AI and emerging technologies into their roadmaps, driving innovation within the core,” she said. “At the same time, point solutions play an important role by delivering niche capabilities that enterprise platforms can’t address quickly or deeply enough. The result is an ecosystem where innovation builds around the platform, while the core provides the infrastructure and capabilities everything else depends on.”
The platform approach doesn’t hamper inventiveness; it “channels” it in a way that favors trust, safety and scale over flashiness, singling out the freestanding applications that can actually be deployed and sustained, said Reid Stephan, senior vice president and CIO of Boise, Idaho-based St. Luke’s Health System.
“Platforms inevitably trade speed for reliability, which can feel restrictive, but without that structure, innovation often dies in pilot purgatory,” he said. “The result for the health IT industry is fewer standalone point solutions and more value created by those who can innovate within guardrails. Because in platform markets, the best idea doesn’t win; the best‑integrated one does.”
Duarte, Calif.-based City of Hope also uses enterprise platforms as a “foundation,” while continuing to adopt standalone applications where needed, said Simon Nazarian, executive vice president and chief digital and technology officer.
“In many cases, the capabilities embedded within large platforms are not as mature as best-of-breed point solutions, and defaulting to platform offerings can mean settling for functionality that is ‘good enough’ rather than best in class,” he said.
Moving forward, “open” platforms that allow health systems to seamlessly connect point solutions will be most successful, Mr. Nazarian said.
“From a broader industry perspective, an overly rigid platform approach risks narrowing the field of viable solutions and discouraging innovation,” he said. “The goal should be interoperability, flexibility and choice, supported by engaged platform ownership that helps guide vendor roadmaps rather than innovation constrained by platform boundaries.”
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