Digital Exhaust #205

My new podcast, Epic's stealth rise of MyChart, a great prompt

Good morning. A few things:

I started a podcast: Freerange MD

I launched a podcast this month — Freerange MD. I'm aiming for amazing conversations right now -- I’m leaning into healthcare and technology. Check out my first episode on On Being a Medical Conservative with Dr.

John Mandrola

from Sensible Medicine. It’s a great interview with a remarkable physician. It's on Apple Podcasts, as well as the Freerange MD YouTube channel. I'll expand to Spotify, etc on the next episode.

I could use your help: Please subscribe, share and review when you can. This stuff helps alot. I would also love to hear from you on future direction with the 'cast. The YouTube channel is a little experiment. I'll be dropping short clips there — Honestly, I’m working to overcome my 'fear' of speaking in front of a camera.

What the travel industry can teach us about Epic's MyChart

Healthcare consultant Seth Joseph wrote a super provocative opinion piece in StatNews this week — I did a quick interview with him. His editorial suggests that Epic has been positioning itself as a gatekeeper to the health care system through its patient-facing portal, MyChart. And Epic could be positioning itself to displace hospitals as the primary point of contact for consumers.

It seems Epic’s MyChart strategy mirrors industries where platforms have disrupted traditional provider-consumer relationships, like the hotel and computer industry.

In 2022 Epic made three major moves to make MyChart a more powerful point of leverage:

1. MyChart Central: They fashioned a unified platform that connects all hospital-specific MyChart instances into a national hub.

2. National patient identity: They created a unified login allowing patients to access providers across health systems and book appointments seamlessly.

3. Encouragement to consolidate: Epic actively pushed hospitals to abandon independent digital front door strategies and rely entirely on MyChart.

The big idea: Epic could influence where patients seek care, transitioning from a behind-the-scenes tech provider to a consumer-facing platform.

And if MyChart becomes a consumer marketplace, these things could happen:

1. Hospital care as a commodity. Just as online travel commoditized hotels, MyChart could make it harder for hospitals to differentiate themselves.

2. Loss of agency. A cautionary tale comes from Dell Technologies, which outsourced its manufacturing to Asus in the early 2000s. Initially, this relationship worked for Dell, but when Asus launched its own brand, Dell’s competitive edge vanished. Hospitals relying on MyChart for consumer engagement risk a similar fate if Epic decides to prioritize its own brand over hospital partnerships.

3. Fee pressures. Platforms like Amazon and online ticket agencies have steadily increased fees on suppliers. Amazon seller fees have risen 19% to 45% of sales over the past decade, making it difficult for small retailers to remain profitable.

4. Pay-to-play dynamics. On Amazon, sellers who pay for Fulfillment by Amazon are prioritized in search results and gain access to the coveted Prime badge. If Epic adopts a similar strategy, smaller hospitals or those with limited budgets could struggle.

So while Epic has been a trusted partner for decades, hospitals should carefully navigate their relationship with the company to ensure they retain control over their futures.

Answers are easy, questions are hard

In 1973 media theorist Marshall McLuhan noted,

The answers are easy, questions are hard. And if you didn’t know that you might spend all of your time looking for answers when you really should be looking for questions.

He was apparently ahead of his time because answers are abundant, and the money is in the question. Understanding and weilding prompts is the next great literacy of this generation.

I stumbled on this great structure for the perfect prompt from Greg Brockman, President of OpenAI:

• Goal – Define what you want clearly.

• Return Format – Specify exactly how you want the response structured.

• Warnings – Highlight any important details the AI should double-check.

• Context Dump – Provide background info to improve the response.

Along with a growing number of great prompts, I've saved this to Obsidian where I collect information like this. A kind of personal wiki, or next-gen Evernote.

Thanks for opening. And as always, please pass this along to anyone