Getting An EPIC Opinion Off My Chest

Posted by

Vince Kuraitis

Posted 12/1/11 on e-CareManagement Blog

We need to be far more explicit in asking a subtle but critical question

What are acceptable bases of competition in health care?

My sense is that the distinctions here are not well understood and often go undiscussed, so I’ll quickly get to the point:

It’s OK for care providers to compete on the bases of quality, price, patient satisfaction, and many other factors

It’s NOT OK for care providers to compete on the basis of controlling or limiting access to patient health information. It’s just not right.

Today’s US healthcare system embraces market competition. For-profit and non-profit health care systems and care providers compete against one another. While we might or might not like this, all I’m asking you to do here is to recognize it.

Hospital based delivery systems work hard to keep patients within their network (walled garden) of providers. That’s understandable. But we need to probe deeper and examine how they are doing this — again, what are the bases of competition.

In many industries we accept the idea of creating proprietary, non-interoperable technology as a means of competitive differentiation. For example, the Apple iTunes system is not interoperable with MP3 players. This is an explicit and intentional part of Apple’s business strategy. I have no problem with this type of competition in digital entertainment.

Health care is different.

We are talking about people here — our children, our parents, our selves. How do you feel when you think about care providers controlling or limiting access to your health record as a business strategy?

Unfortunately, it’s not usually that black and white. In my experience, most organizations do not have an explicit strategy to control or limit access to patient information. More often the strategy is implicit, left over from the era when all records were kept on paper. It’s a default, not a conscious choice.

We need to get rid of this default mindset that anything other thanpatient control of health information is OK. It’s not. It’s not OK to support, enable, or tolerate competition in health care based on controlling or limiting access to patient health information.

The right strategy here will come from your heart, not your business plan.

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