Build vs. Buy: The WELL edition
When you’re in the market for a communication platform, it’s tempting to try your hand at building it. You’ll invest time, people, and a lot of capital up front. But you’ll create something that’s tailored to your needs—and less expensive over the long run. After all, SaaS technology has been around for over 25 years. How hard could it be?
In the great “build vs. buy” debate, we’re the first to admit that we’re biased. But that’s not just egotism. We don’t want to see health systems invest millions of dollars and multiple years into a homemade system that’s hard to maintain and ages quickly.
People tend to focus on building costs—how much is involved in just building an initial product. But that means that the importance (and significant investment) of operations, support, relevant fees, ongoing development, and future-proofing often get overlooked.
To help customers make the best decision, we’ve put together a list of what needs to be built in order to have a communication platform that works for the current market. But then we’ll talk about some of the hidden costs—and the benefit of working with a company whose sole focus is maintaining and developing a best-in-breed product.
And finally, since we occasionally have to make build vs. buy decisions ourselves, we’ll provide some insight into the decision-making process we use. We hope it will be as helpful for you as it’s been for us.
Breaking down building costs
Overall, we estimate that it would take about 20 full-time employees about two years, at a bare minimum, to build a decent communication platform. Costs would be about $4 million. Those 20 employees will need to build and develop protocols for the following.
- Security and HIPAA compliance
- Deliverability and fallback
- Text-enablement for existing lines
- EMR-driven automation workflows
- Vendor-driven automation workflows
- Chatbot automation workflows that are compatible with the above, including a decision tree, natural-language processing integrations, and sentiment analysis
- EMR integrations
- Vendor integrations
- Internal messaging
- Secure web messaging
- Fully bi-directional messaging for both web and desktop applications
- User management that allows you to define different users with unique permissions and access
- Separate functionality and monitoring capacities for administrators and staff
Perfection: a moving target
Build all of that, and you’d have a serviceable platform. We’re pretty proud of what ours can do, and we’ve spent the past few years perfecting it.
But perfection is a moving target, and we’re obsessive about future-proofing. Without continual updates—which are inevitable as technologies, patient needs, and the healthcare industry as a whole change—a communication platform will quickly become dated and clunky.
For example, as healthcare moves toward a value-based payment model, and staying in touch with patients becomes more important, WELL has started building new features to enable post-visit care. Those include forthcoming health maintenance reminders and a new referrals function that helps patients to schedule follow-up appointments.
In addition, we’re always building new integrations and developing new partnerships. We recently configured hours-specific responses, custom holidays, and a brand-new Live Chat feature. We announced brand-new partnerships with InstaMed, Uber Health, RepuGen, and Binary Fountain, designed to provide effortless building, automatic transportation scheduling, increased engagement, and sentiment analysis. As part of our omni-channel strategy, we’re making WELL available through WhatsApp and developing our own iOS and Android app for secure messages.
The development never ends—and that’s exactly as it should be.
Development aside, it would take a minimum of three full-time engineers to maintain the basic functioning of a communication platform—even if it’s a simple one. Those employees would monitor and improve deliverability, perform standard fixes and updates, keep security tight, support integration with the EMR and other vendors, and maintain documentation.
Because occasional bugs are inevitable, even in the best-designed system, engineers need to be ready to jump in to help 24 hours a day.
The price of wisdom
Without a doubt, the hardest thing for us to quantify is our expertise. We’ve spent years working with our customers to develop best practices and provide strategic input. We’ve crowdsourced the best patient engagement techniques and reminder strategies, especially related to when communications are sent and how they are delivered. And we use our communications knowledge and experience to help each health system achieve its own unique goals.
WELL’s support team members have extensive healthcare IT and integration experience. They come to us from companies like Epic, NextGen, and Mirth Connect, and they specialize in integrating between your EMR and our vendor platform based on the actions your health system is already taking. In other words: You continue your existing workflow, and WELL takes care of the rest.
It’s taken us years to develop this depth of knowledge—and remember, it’s our only focus. We’ve made sure that we’re experts in our field, and it’s our pleasure to pass that expertise on to our customers.
Assessing build vs. buy
We’re no strangers to this debate. At WELL, we’ve frequently had to decide whether we want to buy a desirable new technology or custom-build it. To help us make a strategic decision, we’ve compiled a list of considerations—and we hope it can help you too.
- How long will this take to build and implement vs. buy and implement?
- What are the ongoing support costs?
- If we build, what’s the cost to maintain?
- Are there hosting fees?
- Will this need additional after-hours support?
- If we build, what’s the cost to update?
- Will this need additional features or updates over time? If so, what are the costs to develop those?
- Will we need this to integrate with other systems or vendors in the future? If so, what are the development and integration costs?
- What will this cost to specify and design if we build it?
- What are the opportunity costs? Is this taking away from other potential projects that might be a better use of our time?
- Is this a core competency of ours? If not, what’s the cost of developing this as a core competency (i.e. training new staff or broadening our strategic focus)? ♥
If you have any questions about what’s behind the curtains of a communication platform—or anything else—please don’t hesitate to reach out. We’re always available at (833) 234-9355.
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Talya Meyers is WELL’s former Health Editor. Talya began her career in academia before transitioning to writing full time. She has written for Smithsonian Magazine online, BBC Future, Refinery29, and the Los Angeles Times, among other venues. She is a graduate of U.C. Berkeley and Stanford University.