• Seth Joseph

The 1950s Quiz Shows Era And Multisided Platforms: Lessons In Quality Management From 65 Years Ago


For a majority of the 1950s, quiz shows dominated network television programming. They were entertaining, they were broadcast in the coveted prime time slot, and they were new and exciting to watch. It was a win-win for both networks and their advertisers.


They were also fake.


To ensure a winning and entertaining show, and keep the money flowing, broadcasters handed complete programming control over to sponsors. The sponsors would then rig the shows by giving contestants the information they needed to win, all while deeply integrating advertising and marketing into the programming and game itself.


Once word got out that the shows were fixed, the quiz show phenomenon crumbled, but the lessons stand the test of time, and are particularly relevant for businesses building multi-sided platforms (MSP).



MSPs in healthcare: Lessons in quality from from quiz show mistakes


The ultimate demise of quiz shows was because broadcasters gave up far too much (or, complete) control to the advertisers -- the “supply side” of the equation -- allowing the advertisers to rig show content. Advertisers were advancing their own agendas, ethics aside, which in turn cost broadcasters greatly.


Following the quiz show debacle, broadcasters realized the importance of managing the quality of their content and programming. They had to find a way to produce consistent quality content that would still resonate and pull in a large audience -- and thus still attract both viewers and advertisers to the network. The same formula applies to quality assurance for multi-sided digital platforms.


Four critical quality considerations for MSPs

MSPs create value by allowing two or more parties to efficiently exchange information, goods, or services. This value therefore depends largely on the quality of the network itself; from the users it attracts (and who it allows on the platform), to the quality of the exchange itself (the level of standardization of the transaction, the value to each side, how the exchange is supported, etc.)


As opposed to a pipeline business -- where quality control or a product or service, for example, is controlled by the business -- there are different considerations for managing MSP quality.



Four primary ways MSPs can manage the quality of their network are:


1. Upfront certification (or: control access to the platform): One way that MSPs can control for quality is through a certification process. Take Apple’s App Store, for example. All app developers must go through a rigorous review and approval process with Apple’s quality team before getting listed on the App Store. In healthcare for instance, health information networks often have certification processes for electronic health record (EHR) vendors to ensure that they meet certain technical specifications and have identity proofing processes in place such that only properly credentialed providers can send and receive sensitive patient health information (PHI).


2. Leverage the network itself to manage quality through “feedback loops”: Another way to manage MSP quality is to rely on user feedback and feedback loops to inform the quality of certain types of transactions.


In Google’s Play Store, for example, app ratings are outsourced to users; there is no in-house app reviewers or dedicated QA team. Users still gain insight into the quality of an application before downloading or purchasing anything, but they are also the ones driving that feedback loop.


Feedback loops such as this help ensure the quality of the transactions as thus the value of the MSP to users overall.


3. Standardize and manage the exchange process (or transaction) itself: An entirely different approach to solving for quality relates to how MSPs can think about managing the actual exchange process itself.


Redox, for example, is an MSP in health care creating a scalable, efficient way for health care organizations and innovative technology firms to exchange patient data. Recognizing the “many to many” problem (every party implements “standards” in ways that make them not-so-standard), Redox standardizes and normalizes the data and then manages and maintains the software integrations for both sides”, both health care organizations and innovative technology firms.


By solving for and standardizing complex health system tech integrations -- and importantly, standardizing data models that all health systems have, but use different language to convey -- the quality of both the data being exchanged and the experience for users can be managed and improved.


4. The nature of the transaction matters, as does what is being exchanged: Another QA consideration for MPS relates to the nature of the transactions on the network, and how much information consumers and decision makers need in order to facilitate that transaction.


For more common or service-oriented transactions, users might not require a lot of information on network or transaction quality, so long as their baseline expectations are met. For instance, Uber and Lyft ride hailers generally are more concerned with wait times and ETAs than whether the driver is rated at 4.5 or 4.8 stars.


For transactions where failure costs and repercussions are greater, such as renting a place to stay (or hosting strangers) via AirBnB, both guests and hosts typically require significantly more information before executing a transaction.

Potential guests using AirBnB to connect with a host want pictures of where they might stay, and may even prefer to stay with only well-reviewed “superhost”. Hosts, on the other hand, want reviews of their potential guests and as much background information as possible.



Quality management for MSPs in healthcare


For MSPs in the healthcare space, maintaining quality is a non-negotiable. For example, pharmacies receiving e-prescriptions are dealing with live clinical orders that have real patient safety implications attached to them. The cost of not managing quality properly could quite literally impact patient lives.


As the MSP responsible for processing 85% of all prescription nationwide, Surescripts -- the country’s largest health information network -- relies on an extensive upfront certification process to ensure only electronic health record (EHR) systems and pharmacy systems that meet technical and identity proofing requirements (among others) gain access to the network.


Beyond this, and in order to ensure that all participants realize value from the exchange process, Surescripts heavily standardizes the exchange process itself. The company adopts and relies on National Council for Prescription Drug Plan (NCPDP) standards, ensuring that every transaction flowing through Surescripts’ network meets certain minimum quality thresholds; every e-prescription has the same standard set of fields -- some optional and some mandatory -- and those that are mandatory must be filled out in specific, codified ways.



Prioritizing network quality

Whether it’s through feedback loops, certifications, or even standardizing and optimizing the transaction itself, MSPs must prioritize network quality -- building in frameworks from the get-go to ultimately deliver greater value to all users on the network.


Forget the program integrity of “The $64,000 Question.” Nowhere is the potential cost of poor quality greater than in healthcare, where lives can literally depend on the quality of the information being exchanged and the MSP responsible for it.



About Summit Health


At Summit Health, we have spent close to a decade as strategists and operators at the intersection of healthcare and of multi sided platforms. We have done more than study multi sided platforms; we have planned and executed commercial and market strategies, and helped develop new MSP products and scale them successfully. We are passionate about solving inefficiencies in the healthcare system, and believe MSPs offer tremendous potential to improve quality of care, reduce costs, and improve patient access to care.

If you are building a technology platform or network to bring together different healthcare stakeholders to interact with each other and break through opaque and inefficient processes, we'd love to hear from you - please comment or contact us!

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