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On Platform Pulls, Agenticism & Innovation
One of the more challenging dynamics that health system IT executives must manage arises from requests for new applications. Leveraging governance that ensures operational leaders are making the decision (with input from IT), the goal is to reduce app sprawl and data silos by first making sure the functionality is needed at all, then determining if it already exists in-house, and finally examining if an existing platform’s offering meets the need or if a specialized point solution would better serve users.
I recently gained deeper insight into the pull of platforms in my own work life. As LLMs start to pervade existing tools, I’ve seen how my desire to get agentic functionality can be aided by integration and staying within established ecosystems.
Let’s break it down.
Apple I have an iPhone and Mac and don’t think that’s going to change. I love both. In the Apple ecosystem, I’m a power user of Notes and Reminders because I can tell Siri to interact with these apps. My primary browser had been Safari as it works well on the Mac.
Google Our work email is a healthsystemCIO handle, but it’s powered by Gmail. I use Google Calendar and Contacts.
Microsoft I am a super-user of OneNote, which I love. Strangely, while the license I have gives me use of Copilot for Word and Excel on my Mac, it does not for OneNote. I am considering changing my license so I can have Copilot work directly on OneNote content.
LLMs I have a subscription to ChatGPT so can use it independently of everything. I have free accounts for Gemini, Anthropic and Grok, as I wanted to test them out for different things.
Zoom This is the platform I use for meetings and Webinars.
A few issues have recently changed some of my usage patterns. One has to do with the fact that Apple does not seem to have developed a native LLM comparable to the other main offerings (GPT, Anthropic, Grok, Copilot). Since this is the case, I have to go out of the Apple ecosystem, often with a copy and paste approach, to have an LLM act on such content and then bring it back into Apple. This is frustrating and clunky.
I’ll give an example that recently caused me to shift my main browser from Safari to Chrome. Let’s say I want to learn the upcoming NFL weekend playoff schedule and add that directly to my calendar. Well, if I’m either in GPT or a Safari browser, I can’t just tell it to do so because they aren’t integrated with my Google Calendar. GPT will offer to make me a file I can download and then upload, but that’s not what I’m looking for; that’s not agentic.
So, since I use Google Calendar, I decided to try the standalone Gemini app. I asked for the schedule and was provided it. Then I asked it to add the games to my calendar. It said I needed to change a permission or security setting and showed me how. Once done, I said go for it. What happened next was wonderfully agentic – the games appeared perfectly in my calendar – no cut and paste, no download and upload. I thought, this is what I’ve been looking for! How to get more of this good feeling? Well, I thought, if I’m in Chrome, I can either use the native Gemini sidebar to request things be done with either the content on the web page being viewed or information I receive from inquiries made independently in the sidebar.
This, I thought, is the pull of the platform. This is how platforms win. This is exactly what Dr. John Lee was talking about in his recent column (see below). Google had just won my internet browser business (for now, at least), Google had just pulled me deeper into its ecosystem, and this is how the world is currently working. One of the main ways these platforms are fighting for your attention is by offering native LLM integration because the more integration you have, the more agentic you can be, and agenticism (if that’s a word) will win the future.
The Platform-Point Solution Balance
So I’ve gotten a first-hand lesson in the power of integration. When data and functionality live within a connected ecosystem, they can be sliced and diced, moved and shared seamlessly. Best of all, they can work together in agentic ways.
But here’s the reality: we’ll never live in a unipolar world where one platform gives us everything we need. And that’s actually okay. For example, there is no comparable offering in the Google ecosystem for Microsoft OneNote, and that is an anchor of my work life. Sometimes the specialized capabilities of a point solution are so superior, so innovative, that they justify the integration effort required to bring them into your environment. The key question isn’t “Can our platform do this?” but rather “Does our platform do this well enough to meet our users’ needs?”
When a point solution offers functionality that’s significantly better than what your platform vendor provides, implementing it is how organizations stay innovative and competitive. The healthcare organizations that are most successful at managing their technology portfolios recognize when platform capabilities are good enough and when they need to venture outside for best-of-breed solutions that will truly transform their operations.
The platforms want you to believe everything you need lives within their walls, and sometimes that’s true, but there are other times when the most innovative solution exists outside, waiting to be thoughtfully integrated into your ecosystem. The art of IT leadership is helping your organization navigate the difference.
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