Big Tech Should Stay Out of Healthcare

Why the promise of a digital revolution comes with a dark side.

...The use of digital technology in health care has enormous promise, to be sure. But, as the Wall Street Journal's coverage of Google's Project Nightingale revealed, there is also a potential dark side to these projects. Ascension, it noted, "also hopes to mine data to identify additional tests that could be necessary or other ways in which the system could generate more revenue from patients, documents show." That detail raises a key question that's largely overlooked in our health care debates: should the drive to maximize corporate revenues determine how health information technology develops and becomes integrated into medical practice, or should that be determined by medical science and the public?...

Matthew BuckToday's health IT infrastructure is already highly monopolized. Just two corporations, Epic and Cerner, now control 85 percent of the market for electronic health records (EHRs) used by hospitals with more than 500 beds, according to a report from KLAS Research. Epic alone reportedly holds the health records of roughly 200 million Americans. Despite-or perhaps because of-their large market share, these EHR giants produce software that isn't very good. An investigation by Kaiser Health News in March found EHR systems are extremely frustrating for professionals to use and can be rife with errors that can lead to dangerous-and sometimes fatal-results for patients...

An alternative path exists. In the 1970s, the Veterans Affairs Administration (VA) developed VistA, an open-source code system that was the country's first EHR system. Open-source code broadly describes code that users can take and modify for themselves. In contrast, proprietary, closed-source programs such as Epic's often do not allow users to alter the underlying program. Instead, medical providers often have to report a bug instead of just fixing it themselves. As Phil Longman wrote in the Monthly in 2009, the open-source nature of VistA "allowed almost anyone with a good idea at the VA to innovate." In his 2010 book about the VA's health care system, Best Care Anywhere, Longman noted that the agency's "software's code has been continually improved by a large and ever growing community of collaborating, computer-minded health-care professionals."...