Is protectionism hurting health IT innovation?

The results of the U.S. election this month have got me thinking about protectionism.  Webster’s Dictionary defines protectionism as: “the theory or practice of shielding a country’s domestic industries from foreign competition by taxing imports.”  Advocates for a global trade system are obviously opposed to this idea and many attest that even though the strategy seems like a good idea at the time, in the long term it will never really work out.

So why am I discussing foreign policy strategies? I’m a data scientist and eHealth advocate after all. I bring it up because protectionism is exactly what is being practiced throughout the healthcare industry and it is systematically killing healthcare innovation.

Stay with me here.

In my view, there are a few key ingredients required to spur innovation.

• First, a sizeable business problem. Check. No matter whether the system is single payer (here in Canada) or multi-payer (United States), both systems have a significant problem with cost, efficiency, and delivery of care.

• Second, a good flow of capital. Double check. There have never been as many opportunities for investment in health innovation as there are right now.

• Third, accessible technology. Check. From consumer wearable devices, advanced smartphones, VR headsets, social networks, the internet itself: we have a plethora of technology at our fingertips ready to power and distribute the next big thing.

• Lastly and perhaps most crucially: data. Without health data, few innovations are possible. Healthcare, perhaps more than any other area, is completely reliant on data to affect any change.  A physician gathers symptom information, family history, allergies, diet and exercise regimes, all data points used in making a diagnosis and an informed healthcare decision.

And here lies the rub. Health data is some of the least accessible, least available and tightly guarded information we collect.  There are obviously some good reasons for this. Health data is extremely private and should not fall into the wrong hands without your consent. Consider how you might be denied employment, health coverage, other basic necessities (even basic human rights) just because of something within your medical record.

The problem, however, in not with our protocols, laws and security measures to protect this data (at least not completely). Our trouble is with the protectionism practiced by health IT organizations.

Let’s review the definition of protectionism, but instead of a nation, imagine a large electronic health record provider (there are many other examples, I am not trying to single out EHR providers but this is the simplest use case).

An EHR provider (nation) has a lot of patient data, it is their business to catalog and steward this data (domestic industries).  However, their systems, data visualizations and integrations are not always optimized for physicians of patients. Many other eHealth companies with expertise in these areas could innovate and add significant value to this data (foreign competition).  While the long-term outcomes would likely be favorable for both parties, short-term consequences may include erosion of market share or other unfriendly consequences. To combat this, large EHR companies charge high fees (import taxes) to access this data through APIs; effectively pricing innovators (who are most often small with tight capital) out of the market and limiting the speed and efficacy by which the innovation process can occur.

I take issue with the practice, not only because it cannibalizes innovation but because it limits the patient’s (i.e. the true owner of the data) ability to willingly and effectively provide their health information to health IT companies to develop valuable products or interventions.  Without a systematic de siloing of this information, eHealth innovation will continue to occur at this current, muted pace.

We need a better way forward, one which protects the networks and IP of established health IT companies, while also enabling active innovation from the eHealth community. I posit to the stewards of the data: Do not fear the innovators. Engage us in a dialogue about our thoughts and ideas. Create collaborative business models to allow us to access the data we need to innovate. After all, it’s healthcare, we’re all in this together.

Photo: themacx,  Getty Images

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