Competitive Pressures Kill Interoperability…and Not Just in Healthcare

Posted on December 8, 2015 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The past few weeks I’ve been working to get a new cell phone unlocked and transferred from one network provider to another. There’s no need to name names of which networks since they’re all a pain from what I’ve read online. Needless to say, it shouldn’t take me weeks to get a cell phone unlocked and transferred to a new network provider, but it was a total pain.

Think about how much simpler the world of cell phones is compared to healthcare. There are really only 2 standards: GSM and CDMA. In the US that translates to 4 main providers: T-Mobile/AT&T and Verizon/Sprint. Sure, there are a number of smaller providers as well, but there are really only 4 major carriers in the US. You’d think it would be simple to transfer between them since people are doing it all the time. Not to mention there are laws that are passed that require you to be able to switch between providers.

While it seems to have gotten a lot better with these new laws, there are still a lot of competitive pressures for why one network doesn’t want to have someone transfer to another network. It’s in their best interest for it to be difficult for you to switch. That includes your phone not working on the new network even if your phone has all the chips and tech needed to work on it. It’s fair to say that if it was economically good to have that capability, we could seamlessly move between any cell phone provider and be just fine. This is absolutely not a technical issue, but it’s still a challenge to actually do it.

As I was thinking about my experience playing musical cell phones, I couldn’t help but think that the comparison to health care interoperability is really strong. There are competitive pressures for why health care organizations haven’t wanted to share data. New laws are starting to change that, but it’s happening slowly. Far too often I talk to people aghast that healthcare wouldn’t be sharing data with each other. This is far from a healthcare only problem as I saw first hand in the cell phone industry.

Plus, let’s be honest. Healthcare data exchange is at least an order of magnitude more complex (possibly two order of magnitude) than cell phone data. I’m sure the cell phone providers spent plenty of time talking about the technical challenges associated with transferring cell phones from one network to another even though it’s much simpler than healthcare. We all know we’ve had those same arguments in health care for years. I imagine cell networks have even pulled the privacy card that we hear so often in healthcare when you talk about data sharing.

I’m not sure it’s much of a consolation, but I feel it’s good to realize that interoperability is a problem in many industries and not just healthcare. No doubt healthcare has a unique culture and a number of idiosyncrasies. However, I think we have more in common with other industries than most of us realize.

It’s taken the right laws and incentives in place for my cell phone transfer to be possible at all even if it’s still not as easy as it should be. We’re seeing the same thing play out in healthcare. Competitive pressures made it impossible in the past, but that’s really changing. There’s still more work to be done, but we’re getting there.