How liability distribution is holding back certain types of innovation in healthcare

I recently posted about my upcoming  Healthcare Unbound presentation on why healthcare disruption is happening too slowly and requested some thoughts from my readers. This morning I woke up to receive these terrific remarks from Jeroen Bouwens which I’m sharing with permission:

My theory as to what is holding back certain types of innovation in healthcare is the idea of distributing liability. As long as the ultimate responsibility, and therefore liability, lies with the Medical practitioner, they are extremely reluctant to accept automated systems making medical decisions.

At the same time, medical device manufacturers are extremely reluctant to accept liability, because a single system error replicated over many devices can easily result in a company-destroying avalanche of lawsuits.

The result is medical devices that, for all the fancy user interfaces, soothing colors and sexy design enclosures, are still nothing more than dumb terminals that do whatever the doctor tells them to do

Ok, maybe that is not entirely fair to modern devices, which are, in some ways, much more advanced than in the past, but it also not that far from the truth.

I mentioned to Jeroen that I agree with his assessment. I do think that a lack of clarity of what happens with liability within an ecosystem of trusted partners and how that liability is appropriately and fairly distributed is probably a great impediment to innovation in healthcare.

My specific experience in the medical device development community leads me to believe that the lack of connectivity between devices can, indeed, partly be blamed on no single vendor wanting to take on additional liability for another vendor’s errors or data.

What do you think about liability distribution? Are there are other things you think are specifically holding back innovation in healthcare? Drop me a comment here or send me a private email if you’d like to discuss it further.

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3 thoughts on “How liability distribution is holding back certain types of innovation in healthcare

  1. Shahid,
    Let me comment about the Clinical Decision Support implementation and fear of liability.

    I am a full time practicing physician, chief software architect as well as one of the co-founders of a healthcare IT startup. I think you are correct in saying that fear of liability is holding up innovation. Specifically in the case of Clinical Decision Support, an interesting model could be that the functionality be build in the system, but the actual rules be generated by the clinical specialists. This model would entail certain liability for physician as well as IT vendor. For the IT Vendor having such a feature will invariably increase attractiveness of their product to their clients, In case of providers, a well designed CDS rules engine based on underlying discrete data elements is a true blessing.

    Of course, there are many pre-requisites for good provider adoption, including easy to use, intuitive user interface, ability to generate relevant CDS rules, above and beyond what is being mandated as a part of meaningful use . CDS, while important at a population level is often not considered as true measure which makes a physician efficient while improving patient care.

    We have over last 6 years developed an information system for cardio-vascular specialist that has been implemented in a large single speciality cardiology practice. We just started to reap the benefits being able to mine discrete data elements from the repository to generate CDS in the EHR. Currently system can hold more than 5000 discrete data elements per patient. True vendor neutrality is another important feature that will make the adoption by an institution easier.

    I look forward to the conversation and your point of view.

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