The CDS platform landscape
How different companies are shaping access to the patient data, clinical systems, and physician workflows required to deliver CDS
Four archetypes
There are various companies who might eventually manage the ‘last mile’ infrastructure for Clinical Decision Support (CDS). The landscape is currently fragmented, with varying maturity and consolidation across geographies. I see four main archetypes today:
1. ‘Classical’ evidence-based content aggregators: These companies are increasingly turning ‘AI’ and seeking to advance their capabilities. Recent announcements from the likes of Elsevier and Wolters Kluwer highlight the trend in this direction.
2. Care automation companies ‘land’ by demonstrating early value through the efficiency & quality improvements, then ‘expand’ to more advanced CDS services. I am looking at the impressive scale-up from Tactuum in Scotland, and companies such as e18 innovation and their work in the UK.
3. CDS aggregators / integrators are adopting a more ‘top down’ approach to platform development with a heavy focus on ability to read-write across (oftentimes multiple) EHRs and/or other data systems. We see this in the US with companies such as Redox, and several ex-US companies. Canada also is notable for the increasing vertical integration under Healwell. Other plays include EHRs themselves (the most well-known example being Epic’s showroom), pharma (Roche Navify), or even health systems (Mayo Clinic).
4. CDS HealthTech & Tech Services companies represents the most diverse group. More mature digital care delivery companies may enter the CDS space, leveraging their existing integration into EHR as well as their ability to accompany the CDS with complimentary solutions & services supporting patient journey management. HealthTech and Tech Services companies already involved in the development and deployment of CDS solutions (including us here at ZS) also have opportunity to expand their ‘last mile’ capabilities and platforms.
How can pharma navigate this landscape?
Pharma is increasingly looking to develop and deploy CDS solutions to help accelerate patient diagnosis, improve treatment decision-making, and optimize patient care & outcomes.
- Make a choice: This sounds obvious, but is important to mention. Pharma needs to make a strategic choice on whether to actively participate in the development (and in some way, ownership) of ‘last mile’ management infrastructure or if it is comfortable to leverage partnered platforms (and if so, under what conditions).
- Plan for a modular approach: Similar to the RPM landscape, the CDS ‘last mile’ landscape is likely to remain fragmented. Plan for an API-based system whereby different CDS platforms can pull your algorithm and/or other relevant content.
- Establish a partner network: Proactively forge the partnerships with the key ecosystem orchestrators who are operating across regions, enabling you to deploy across multiple companies in parallel.
- Build the right capabilities: Whether pharma sees CDS as a tactic or the central enabler of a new business model, it will still need to build out a certain degree of in-house capabilities (product, tech, regulatory, etc.) to either own or partner on CDS.
- Work with a trusted 3rd party: Leverage a trusted 3rd party, such as ZS, who is able to navigate the diverse landscape and take an appropriately company/tech-agnostic approach to supporting strategy, product development & implementation at scale.
