Twitter’s Fate Depends On Elon Musk’s Understanding Of Platforms; Healthcare Can Learn From That

Little has generated as a lot media consideration previously week as Elon Musk’s $44B potential takeover of Twitter. “My robust intuitive sense is that having a public platform that’s maximally trusted and broadly inclusive is extraordinarily essential to the way forward for civilization,” Musk famous at a current TED convention. By most accounts, ‘inclusive’ right here means the safety of speech; it’s not sure what he means by ‘trusted’, though addressing that part might be essential to the success of this new endeavor, as Twitter is a platform whose supply of worth will not be the product itself, however the community of 396 million individuals (of whom 77 million are within the U.S.).

In that respect, Twitter represents a really totally different sort of enterprise than the opposite three firms Musk runs in Tesla, SpaceX, and The Boring Firm. These different firms are all ‘pipeline’ firms, which create worth by controlling elements of a worth chain; Tesla, as an example, could depend on suppliers for some elements, however controls the design of the top product and the way these elements are put collectively.

Twitter manufactures nothing, and if something, the merchandise themselves are tweets produced and consumed by the individuals utilizing the platform.

Musk has confirmed sensible at engineering new options to a number of the world’s hardest challenges. And he was an early govt at PayPal, a fee platform. However that was 20 years in the past.

Can Musk efficiently run a can he run a multi-billion greenback platform firm, the place he received’t be capable of flip a swap to flip a swap to alter human conduct? And what can the healthcare trade and digital well being platform firms be taught from a pipeline knowledgeable taking on a platform enterprise, particularly in an trade that’s vastly totally different from these through which he’s operated to this point?

Under are a number of the essential factors that healthcare platform firms, traders and companions should bear in mind as they develop, launch and develop their companies, based mostly on Musk’s proposed acquisition of Twitter:

Pipelines versus platforms:

• Twitter: Elon Musk is a talented operator of pipeline companies, with Tesla and SpaceX his two greatest endeavors. Per the above, pipeline companies take possession of a portion of the group’s worth chain, create worth by means of differentiation of a selected set of actions, after which promote the fruits of their labor (e.g., Tesla proudly owning the end-to-end manufacturing and gross sales channels). Versus pipeline companies, platforms facilitate trade between totally different sides of a community; usually, one aspect is a producer or provider (of data, companies, or items), and one aspect is a shopper, with monetization based mostly on the power and breadth of the community.
• Healthcare: There are only a few (however growing) digital well being platform success tales: Surescripts, CoverMyMeds, GoodRx and Doximity being a number of the pack leaders. Platform companies are notoriously troublesome to scale in any trade, and healthcare is extra complicated than most: it’s extremely regulated, has a posh fee system, interacts with individuals’s most delicate information and serves them throughout essentially the most delicate instances of their lives, and healthcare itself will not be a standard financial good.
• Lesson: platforms are totally different, and require very totally different experience to run, develop and scale than most skilled healthcare executives have. Firms in search of to construct platforms ought to search to know the variations between pipeline and platform companies. There’s a burgeoning discipline of literature on the enterprise of platforms; sadly, a lot of it interprets solely loosely to healthcare, so founders, traders and executives ought to be conscious and sensible about what it’s going to take to attain the flywheel impact of platforms in healthcare.

Energy of platforms:

• Twitter: Twitter is only one of many platforms that’s modified the best way society interacts; Musk calls it the “public sq..” Platforms are normally pushed by network effects: the concept that the platform good points extra worth because the variety of customers will increase. Taking note of not simply the platform capabilities, however how these capabilities manifest in person transactions with one another, is essential. For platform networks, it’s the presence of different customers that may most probably entice them and hold them there (or repel them), so creating an in depth eye on person interactions themselves is essential.
• Healthcare: Alternatives for network-effects pushed platforms in healthcare abound. Take into consideration the flexibility to attach individuals looking for healthcare companies with suppliers (for instance, Buoy Well being). Or a community that connects main care physicians with specialists in a position to present well timed consults nearly (equivalent to RubiconMD). Or a expertise platform that connects digital well being firms to hundreds of well being methods, decreasing the necessity for an costly one-to-one integration (equivalent to Redox). There are quite a few alternatives for platforms to match individuals with companies they want, to cut back info asymmetry, and to resolve for info silos. There’s maybe no different trade exterior of healthcare who may benefit from these capabilities extra.
• Lesson: Funding in digital well being has been rising steadily for years, reaching $29 billion in 2021. Rising even sooner? Funding in digital well being platforms, and for good cause.

The significance of belief and governance:

• Twitter: Musk purchased Twitter to cut back “content material moderation.” Twitter (and Fb) each applied content material moderation in an try to cut back the unfold of misinformation. Questions now at hand embrace how customers ought to be verified, and what sort of conduct and/or content material ought to be allowed on the platform so as, as Musk notes, to “construct belief” within the system. Whereas Musk could wish to scale back content material moderation (or maybe change how content material is moderated), such motion is dangerous, as it could erode person and public belief within the security of the platform: if customers don’t really feel secure, they might drop off solely. Of observe, the current mass account deactivations after the Musk deal was finalized, says Twitter, have been simply “natural fluctuations,” and never from any bot-purging. In actuality, this can be a warning-sign about Twitter customers’ notion of how the platform might be ruled going ahead.
• Healthcare: Belief in healthcare is sacrosanct: the doctor-patient relationship is paramount, and the whole lot should circulation from that. Whereas each well being expertise firm should implement stringent privateness and safety insurance policies as a part of their core operations, platform operators in healthcare should do with with the conclusion that each person depends on the platform to vouch for each different person.
• Lesson: Create guidelines of the street so customers have faith within the integrity of the community, and supply the required oversight to guarantee customers their greatest pursuits are additionally your greatest curiosity. Create mechanisms for suggestions loops – equivalent to community advisory boards – to make sure that considerations are raised and heard, and additional insurance policies be established as vital.

What high quality means in a platform context

• Twitter: Following and unfollowing, muting accounts and key phrases, and curating how a person’s feed is displayed are mechanisms that enable customers to handle their very own expertise on Twitter. Some have argued for an ‘edit’ operate as soon as tweets are posted (which raises its personal query, equivalent to: what if I retweet one thing that turns into edited and now not displays what I favored concerning the tweet?). A recent article catalogs user-generated concepts for performance to supply customers the flexibility to enhance their very own expertise of the platform.
• Healthcare: Investing early to determine the core use case is essential. Interoperability as an entire has largely failed due to poor deal with high quality of person expertise, and what represents the core use case for every constituent (trace: everyone is in search of various things at totally different instances, which makes it troublesome). Customers throughout a wide-array of digital medical information (EMRs) and interoperability networks are fairly acquainted with the complexities and lack of high quality information that crosses these platforms each day. Functions with a really slim focus and use case, like e-prescribing, are exceptions to the failures the broader and less-focused networks have seen to this point.
• Lesson: Begin with a slim focus and be use-case particular. Work out what makes the distinction between a profitable interplay and a foul one for various customers, and hold refining till there success will be repeated and scaled. Be conscious that, as extra customers come onboard and new use circumstances are thought of, every person’s wants and preferences could evolve.

Monetization choices:

• Twitter: The social platform has had bother monetizing its community of customers, however has primarily pushed income by means of conventional promoting on its customers’ feeds. It has not been in a position to match its social media rivals’ skill to monetize their networks, nevertheless, and has largely been seen as struggling enterprise within the social media world despite its outsized impression on public conversations. Given Musk’s $44 billion price ticket and Twitter’s 2021 income of $5 billion, it’s honest to imagine {that a} key space of focus would be the firm’s skill to monetize (Musk’s protestations however).
• Healthcare: Totally different firms have developed totally different methods, however monetization usually happens on one aspect of the community, with potential subsidization of the opposite aspect of the community. CoverMyMeds, a multi-sided platform that connects docs, pharmacies and pharmacy profit managers to enhance the prior authorization course of, found out {that a} novel path to monetization: it charged no person utilizing the community, however offered information and analytics to pharma manufacturers in search of to benefit their very own merchandise available in the market.
• Lesson: Monetization in platforms is a wholly totally different animal than pipeline companies. It’s essential to evaluate all sides’s willingness to pay; understanding underlying economics of every aspect (and whether or not exterior events are related) may also be useful.

Whereas healthcare and social media are extraordinarily totally different industries, the ideas of platform technique growth can apply in each contexts. For Twitter’s sake, let’s hope that Musk is aware of as a lot about platform companies and folks as he does about constructing vehicles and sending his new Twitter customers to Mars.