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Why American medicine still runs on fax machines
https://www.Vox.com/health-care/2017/10/30/16228054/american-medical-system-fax-machines-why Great article explains how the inability to kill the “cockroach of American medicine” illustrates the incentives or anti-incentives toward data sharing & interoperability HT @DShaywitz

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“Competitive pressure between the companies that sell electronic record makers themselves only made things worse. The electronic record makers don’t have much incentive to connect well with other records, when they’d rather just convert that hospital on a different electronic platform into one of their own customers.

“When you want competing entities to share information, you have to realize that they’re sharing things that could help their competitors” “If [electronic record vendors] expended all that time and effort to make it so anyone could plug into any other system, it’s reducing the advantage of staying on your particular network,” Mostashari says.

This is especially true for larger electronic medical record companies, which want to sell the advantages of joining a record that is used in lots of doctor offices. “You want to make it easier for people to say, ‘Hey, if you’re on [our electronic record], look how awesome it is! You can talk to any user, anywhere in the country,” he argues.

In short, economics gave hospitals plenty of reasons not to connect their records with other hospitals — to stick with a clunky
technology, like fax, that makes it hard to transmit information. And the government didn’t give any incentives to connect — it stopped at digitizing medicine, falling short of the interoperability that patients actually want.
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