The 21st Century Cures Act: A Competitive Apps Market and the Risk of Innovation Blocking

The 21st Century Cures Act and the recently published “final rule” define standardized methods for obtaining electronic copies of electronic health record (EHR) data through application programming interfaces. The rule is meant to create an ecosystem of reusable, substitutable apps that can be built once but run at any hospital system “without special effort.” Yet, despite numerous provisions around information blocking in the final rule, there is concern that the business practices that govern EHR vendors and health care organizations in the United States could still stifle innovation. We describe potential app ecosystems that may form. We caution that misaligned incentives may result in anticompetitive behavior and purposefully limited functionality. Closed proprietary ecosystems may result, limiting the value derived from interoperability. The 21st Century Cures Act and final rule are an exciting step in the direction of improved interoperability. However, realizing the vision of a truly interoperable app ecosystem is not predetermined.

The 21st Century Cures Act: A Competitive Apps Market and the Risk of Innovation Blocking (Preprint)

UNSTRUCTURED The 21st Century Cures Act and the recently published “final rule” define standardized methods for obtaining electronic copies of electronic health record (EHR) data through application programming interfaces. The rule is meant to create an ecosystem of reusable, substitutable apps that can be built once but run at any hospital system “without special effort.” Yet, despite numerous provisions around information blocking in the final rule, there is concern that the business practices that govern EHR vendors and health care organizations in the United States could still stifle innovation. We describe potential app ecosystems that may form. We caution that misaligned incentives may result in anticompetitive behavior and purposefully limited functionality. Closed proprietary ecosystems may result, limiting the value derived from interoperability. The 21st Century Cures Act and final rule are an exciting step in the direction of improved interoperability. However, realizing the vision of a truly interoperable app ecosystem is not predetermined.

The Political Replacement Effect in a Kinetic Model of Social Dynamics with Phase Transition

The political replacement effect is an interesting socio-political hypothesis introduced by Acemoglu and Robinson and statistically tested. It may determine, under some conditions, the phenomenon of innovation blocking, possibly leading to economic backwardness in a society. In a previous paper, we have introduced a kinetic model with stochastic evolutive game-type interactions, analyzing the relationship between the level of political competition in a society and the degree of economic liberalization. In the present paper we model we model the possibility of having a sort of phase transition occurring in the system when the phenomenon of blocking of the introduction of technological innovation, intended in a broad sense, appears. Crossing a critical point, the rules of interactions change by means of slightly different transition probabilities nevertheless determining very significant differences in the resulting long-term solutions.