ACM guidelines regarding the competition rules for the health care IT market have been well received

The guidelines called ‘Well-functioning markets for health care IT’ clarifies the application of the competition rules for improving the functioning of the market for health care IT systems. In the summer of 2022, the Netherlands Authority for Consumers and Markets (ACM) published the draft version of the guidelines for public consultation. The responses from various market participants have revealed that the guidelines as well as ACM’s approach to the health care IT market enjoy broad support.

Following the responses, ACM has given more attention to the consequences for patients if the health care IT market does not function well. Various responses also point out the international dimension of the health care IT market. ACM sees that the Dutch market is difficult to enter because of the high investments that are necessary, a lack of IT standards, and because switching barriers for health care providers are high. All responses have been summarized in a consultation report and were incorporated into the definitive guidelines.

What are the risks in the health care IT market?

Data exchange in the Dutch health care system is not at the desired level because the IT systems that are used do not sufficiently support the exchange of data. Only a limited number of health care IT suppliers are active, and health care providers often are highly dependent on them. Switching suppliers is difficult and expensive, for example, because health care providers have already invested so much in the use of their systems, and these systems are linked to many other systems. Such a dependency may lead to vendor lock-in. That restricts the efficient exchange of data, and leads to higher prices, reduced quality of care, and less innovation.

What do the guidelines on health care IT explain?

The guidelines explain the competition rules for health care IT markets. If a supplier abuses its dominant position, it is considered a violation of the Dutch Competition Act. Abuse of dominance in the health care IT system market could take place in real life as making it difficult to link systems of different suppliers, imposing unfair conditions (contractual or otherwise), or charging non-transparent or excessive prices.

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.

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 are able to function better if it becomes easier to link systems to each other or if the quality of such links improves. To that end, uniform data-exchange standards, such as uniform language and technologies, are needed. At the moment, the Dutch Ministry of Health, Welfare and Sport (VWS) is already making great efforts in that area through rules and regulations. In that process, ACM advises the minister to follow as much as possible open international standards 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 are of great importance to the quality, affordability and accessibility of health care in the Netherlands, now and in the future. 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. ACM’s attention to IT in health care is part of ACM’s focus area The Digital Economy.

More in this case

• 22-11-2022 Definitive guidelines ‘Well-functioning markets for health care IT’ (in Dutch)
• 22-11-2022 Consultation report belonging to ‘Well-functioning markets for health care IT’ (in Dutch)
• 20-12-2021 ZIS/EPD systems: market problems and possible solutions, the current state-of-play (in Dutch)

See also

• 18-06-2021 Sector inquiry into the market for information systems and exchange of information in hospital care (in Dutch)
• 22-03-2022 Market survey into information systems and digital data exchange in the hospital sector
• 01-07-2022 ACM guidelines to clarify competition rules for health care IT markets