Previously, I wrote on the topic of bio-diversity as related to standards (read post here). I read an interesting post on slashdot.org that is prompting me to re-visit the idea of bio-diversity in health care, and specifically in eHealth.
As we know from our high-school biology classes, “bio-diversity” means having a variety of biological matter, be it genetic material (i.e., genes, DNA, etc), different species, and different types of life forms (for a more in-depth description, you can view the wikipedia.org entry here). Basically, the concept asserts that having a selection of biological options is advantageous because the diversity provides greater protection from catastrophic events like disease, natural disasters, and other conditions. Basically, the example everyone likes to use is when only a single species exists (like us homo homo sapiens), the risk of a single disease or event wiping out the species increases because there is essentially no difference between people. Thus, a disease that makes one of the species vulnerable makes everyone vulnerable. The concept of bio-diversity suggests that having differences in each person increases the likelihood that there will be some form of resistance on the gene pool somewhere. I liken this concept to a derivative of what we learn about evolution – that only the most strongest and most adaptable survive.
Anyway, in terms of eHealth, I wonder if we are going to suffer from a lack of bio-diversity. For one, we see that the smaller vendors are either being bought and consolidated or simply closing shop. On the one hand, it’s not such a bad thing that the small vendors are closing because they probably can’t provide the enterprise leve support that hospitals or regions are wanting. Let’s face it, the trend in health care is towards bigger, regionalized, and (dare we say) “centralized” forms of care all mediated and facilitated by technology. If this is the case, then we are also moving toward fewer and fewer options.
Now, to exacerbate the issue, hardware vendors (and perhaps software vendors too) do not only supply products to health care. As we read in the slashdot.org post, hardware vendors may be slowly discontinuing products that other industries no longer want (makes sense), but that health care may need. Health care has different needs than the financial services, technology, or consumer goods industries.
Now that I think about it from a bio-diversity perspective, I wonder (and this is just a “think outside of the box” type of thought) if having a fragmented health system has any value at all. I mean, not having a single information system keeps risks of breaches and system-wide failure at a minimum because we aren’t connected to one another. Also, by having hundreds of different alternatives, there is a greater opportunity to identify the elements that are beneficial and effective. Okay, practically speaking, this isn’t such a good thing. Variety is good, but how much variety is sufficient?
As an industry, does health care and eHealth need to push the technology vendors to pay more attention and provide more options? Why can’t new and innovative products be developed for health care and then be pushed out to other industries rather than the other way around? As an industry, do we need to ensure that competition and health alternatives remain in order to maintain the biodiversity of the system? Perhaps that’s why the technology industry (in general) has been so successful – there is plenty of competition and diversity to churn out new and innovative products. Diversity is welcomed and encouraged.
With this push for efficiency and “economies of scale”, are we trading short term “gains” for potentially long-term pain? Are we digging our own grave?