1) Denmark aimed to create common processes and data structures across 13 municipalities and multiple medical vendors from 2002-2007, but faced issues with too many concurrent users and high data transmission. 2) From 2007-2012, Denmark established a shared medication record and common database to address prior issues. 3) The document discusses various roles that medical intermediaries can play, including consumer/professional content aggregation, patient management, records management, physician career services, and more. It also covers intermediation theory and the challenges in Europe.

1. B2B Medical Intermediaries
Jonathan Wareham
ESADE – Ramon Llull Univeristy

2. Denmark= 5.5 million people
2002-2007
•Global Patient Journal
•13 municipalities – multiple vendors
•Goal = common processes & data structures
•Operations – too many concurrent users & high data transmission
•Design focused on functional design, not architectural (operations)
•Lack of centralized semantics/processes/
•Need of centralized arbiter & political power
2007-2012
•Shared Medication Record
•Common DB

3. An Old or New Phenomenon?

4. What we found 1
• Consumer Content Aggregation - consumer education
and empowerment
• Professional Content Aggregation – online clinical DB,
and diagnostic tools
• Consumer Retailing – health supplies, vitamins &
pharmaceuticals
• Patient Management – booking, case data and
diagnostics
• Records Management – digitization and management
of patient records

5. What we found 2
• Physician Career - Recruitment, Licensing & Training
• Insurance Claim Processing –clearing and processing
of insurance claims, data cleansing & verification,
revenue management
• Supply Chain Management – Integration with chosen
vendors of medical supplies for purchasing and
inventory management
• Procurement tools & markets – Asset acquisition and
management/maintenance, resale, compliance
• Application Service Provision – Consolidate application
on single platform.

7. Intermediairies

8. Intermediation theory
• Information Management: as an aggregator and filter
of information (supply and demand)
• Transaction Securitization: controlling and
guaranteeing the products delivered and assuring
payment to producers,
• Logistics Management: sorting, packaging, storing,
stocking and transportation of goods from production
locations to intermediate warehouses to consumption
sites.
• Market-making/liquidity: by purchasing production
before consumer demands are expressed, the
intermediary provides producers with some stability and
security of demand for their production. Extend credit to
both sides of transaction.

9. Results
Klein R. and J. Wareham “Healthcare Intermediaries in Electronic Markets: Performance and Choice of Market Entry Mode,”
Journal of Electronic Commerce Research 9(4) 2008. pp. 243-259.
Information
Management
Firm
Logistics NS Age
Management 0.202*
1.056**
Healthcare Publicly
Intermediairy NS Traded
Performance
3.055***
Market Making NS Pure-Play/
Liquidity NS Traditional
Transaction
Securitization

12. European Perspective
• Natural Monopolies
• Information Aggregation difficult to defend
• Opportunities to benefit from fragmentation on
national level
• Public/Private transactions or exchange
• European level – even greater
• HL7 or other EU standards