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ACM guidelines to clarify competition rules for health care IT markets

No impediments to the exchange of data, no abuse of vendor lock-in, but, at the same time, giving room to collaborative procurement among health care providers, and the use of standards. These are some of the recommendations in the draft version of the guidelines called ‘Well-functioning markets for health care IT’, which offers certainty to health care IT suppliers and health care providers in order to ensure that health care markets work better. The Netherlands Authority for Consumers and Markets (ACM) has published the draft guidelines for public consultation thereof over the next few weeks. ACM expects to finalize the guidelines in the fall.

Martijn Snoep, Chairman of the Board of ACM, explains: ‘The exchange of data in the Dutch health care sector is lagging behind. Health care providers are highly dependent on IT systems for providing high-quality care to their patients. That is why a well-functioning health care IT market is absolutely crucial for the quality, affordability, and accessibility of health care, now and in the future. There is often a limited number of IT suppliers to choose from. We also see that switching IT suppliers is very difficult and expensive. However, IT suppliers cannot foreclose markets. That restricts the efficient exchange of data, and results in higher prices, reduced quality of care, and less innovation.’

What are some of the risks in the health care IT market?

Health care providers often are highly dependent on their health care IT supplier. Switching suppliers is difficult, for example, because they have already invested so much in their systems, and these systems are linked to many other systems, or because transferring the data is problematic. Such a dependency may lead to vendor lock-in. If suppliers abuse such situations, they act in violation of the Dutch Competition Act.

What do the guidelines on health care IT explain?

The guidelines explain and gives concrete examples of the competition rules for health care IT markets. The guidelines also contain descriptions of the types of practices that are prohibited. For example, abuse of dominance may take place in real life as making it difficult to link systems of different suppliers, as imposing unfair conditions, or as charging non-transparent or excessive prices. IT suppliers and health care providers can test their conduct against the guidelines, and adjust their conduct if necessary.

According to ACM, health care providers are able to countervail the strong position of IT suppliers. They can combine their knowledge, experience, and buyer positions by working together more efficiently. The guidelines describe the opportunities for collaborations within the competition rules. Any agreements between market participants regarding technical solutions, uniform language, and standards promote the interoperability of health care IT systems and the digital exchange of data. That is allowed, and is also encouraged in order to ensure that markets work better.

Launch of investigation into reports in the health care IT sector

As part of the drafting process of the guidelines, ACM has had many discussions with different market participants, and has received various reports. These have prompted the launch of an investigation into the question of whether competition rules have been violated. In that context, practices that may unfairly hinder interoperability will be prioritized. ACM is calling on all market participants to come forward and submit concrete reports about any practices that impede the proper functioning of health care IT markets.

Ministry of Health, Welfare and Sport (VWS) to spearhead the standardization of data exchange

Both the health care sector and the health care IT sector benefit from improved opportunities to link systems on the basis of uniform data-exchange standards. In that area, the ball is in the court of the Ministry of Health, Welfare and Sport (VWS). In that context, ACM advises the minister to follow as much as possible open international standards (existing or otherwise) in health care IT, so that the market continues to be open for all IT suppliers.

ACM and health care IT

Well-functioning IT markets in the health care sector are a necessary condition for well-functioning health care markets. Open information systems of health care providers offer many opportunities for an effective and timely exchange of data, and for innovation. With such systems, health care providers and patients will have the right information in the right spot at the right time. That is needed for making the quality, accessibility and affordability of health care in the Netherlands ready for the future. ACM’s attention to IT in health care is part of ACM’s focus area The Digital Economy. 

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