In an opinion column at MIT Technology Review, authors John Palfrey and Urs Gasser discuss the problems that can arise, including privacy issues, as the world becomes increasingly interconnected through network systems.
The Internet solves problems for individuals as well as at the societal level. As we seek to address society’s most pressing issues—such as climate change, for instance—we are building increasingly complex infrastructures, including next generation transportation systems and the smart grid. These complex systems rely heavily on digital technologies that connect systems and organize the flow of data between and among them.
Most of the time, this high level of interconnection is purposeful, and in fact helpful. Sometimes, however, we can take this interconnection too far, without thinking through its consequences. Security and privacy risks are the most common problems that flow from unchecked levels of interoperability. Worse still, the most highly interconnected systems, such as the international financial system, can give rise to catastrophic domino effects. Whether the instrument is complex derivatives gone bad or computer malware, harm can flow across highly interconnected systems and cause knock-on effects far from where the initial harm occurred.
When we consider the costs and benefits of high degrees of interconnection in this way, what we are talking about is interoperability—the theory of highly interconnected systems—or interop, for short. […]
The problem with electronic health records is interop. While the health and economic benefits of a system of electronic health records are obvious, we don’t have electronic health records that can work across systems for a wide range of complicated reasons. One is legacy systems: hospitals and insurers have invested over the years in a hodgepodge of different systems that do not talk to one another. It’s expensive to make them work together and it’s expensive to move to new systems. Some health-care providers and insurers don’t actually want the higher level of interconnection across systems, because it might lead to new forms of transparency, as well as potentially liability. It takes time to load in the data and time to analyze it. And then there’s the pesky issue of privacy: if we make these systems highly interoperable, we need to ensure that privacy and security safeguards are more robust than they are today.
It’s our view that a concerted effort by the government, in partnership with industry, can lead to high levels of interop in electronic health records. The federal government will need to keep pushing and creating incentives for compliance. The government, after all, is a major consumer of health-care information systems. Even through its purchasing power, the government has a great deal of authority in this area.