Government Platforms — the Case of Healthcare
Platforms are powerful tools that many times make the difference. They might start as a simple software, protocol or even a device, but then evolve to be the ground upon which other elements are built. They essentially create the proper environment for entrepreneurship, innovation and creativity to prosper. In the digital age, when physical space looses its importance, platforms enable remote, low budget enterprises to flourish, along with the more upscale complex and costly productions.
A simple and well known example for a platform is Facebook. Probably Facebook started as a social network with relatively limited features, but quickly evolved to a digital environment in which many application are built on, practically transforming the way people interact on the global level.
Digital platforms challenge the way governments serve their citizens. In a sense, the question is whether, in certain areas, governments should provide the services themselves, or just provide the proper platforms on which the other sectors will develop and provide the services in a much more efficient way? As technology develops on a pace that tremendously exceeds the operation speed of even the most efficient governments, the answer becomes clear.
So what is the downside of (digital) platforms? Are there any? Well, of course there are. Here’s one: As successful platforms evolve, they can become monopoly, dominating a market. Think about Facebook. What will happen if this platform will crush or malfunction? What will be the financial implication of such an event? Can it cause disruption of social order? Danger individual lives as they loose their major way of communication with the world, of getting feedback and doing business? Can such a company go to the ‘dark side’, manipulating its individual members, or large organizations, even countries?
Platforms in general have limited life span. Low tech platforms that are abandoned leave their mark long after they’re gone. Think about the future when most of the traffic will be on air, people flying to work in their personal air crafts. What then will be with all the roads and subways? Digital platforms are no exceptions, as they grow old, they loose their flexibility and at some time replaced by a new one that is based on newer technology, have extra or better features or just more friendly. People adapt quickly in cyberspace with no physical remnants left for historians to study upon.
Let us now move to Healthcare. Healthcare is characterized by high degree of specialization and government involvement, at least in modern countries with advanced social systems and universal healthcare. In my country the government is inefficiently providing some of the services while most of them are provided by highly centralized non profit public HMOs (Health Maintenance Organizations), who do this job for the government. There are many problems in any of the healthcare systems in any of the countries, but lets discuss one of them as an example of a potential intervention of a government providing a platform.
When patients are referred for a treatment, whether it is a consultation, an imaging study (CT scan for example), or a procedure (Colonoscopy or hernia operation for example) they need to get an administrative authorization from their HMO and then make an appointment for the service. This might sound simple but the truth is much more complicated as the patient need to make an appointment to the administrative staff and then is confronted by the need to know his options for having the service. As bad as it sounds, these tasks are not easy to accomplish. Nevertheless, digital systems are natural solutions to theses problems not only on the organizational level but on the national level. This can only be accomplished by the government, creating a digital platform for any of the patients, HMOs and service providers to digitally ‘close the loop’ by administratively authorizing the service, providing nationwide information about all the service providers and their time availabilities, and actually making the appointment.
This is just one example but others can also be thought about. Think about the (near?) future when computers will replace physicians, making much of their clinical reasoning of diagnosis and treatment plans. These tasks will be supported electronically by new ways of monitoring, testing and imaging that will be available in anyone’s home, as wearable devices, smart phone applications or other developments we cannot imagine in this time. What will be then the role of our government? One possible answer is to provide the proper platform for this reality to materialize in a safe and reliable way.
As future unfolds governments should be open and flexible enough to adjust the way they exercise their responsibilities. Probably one of the ways to do so is providing platforms.
