Once again, Buff Colchagoff, CEO of RosettaHealth, authored his annual holiday article for Healthcare Now Radio, which drew on the classic Christmas movie Elf and the concept of the “tragedy of the commons.”

As always, Buff provided some creative parallels between popular culture and key health information exchange challenges. For example, he pointed to how New Yorkers, in the movie Elf, collectively displayed Christmas spirit to allow Santa’s sleigh to fly.

We need this kind of collective spirit to overcome the “tragedy of commons” challenge that is common in today’s health data exchange arena. The tragedy of commons is the idea that individuals will operate in their own self interests when they have “open access to a resource unhampered by shared social structures or formal rules that govern access and use.”

In our industry, the commons is represented by the national exchange networks, which are eHealth Exchange, CommonWell and Carequality. The users are the organizations that connect to those networks. In particular, Buff points to these challenges being the tragedy of commons:

• Network participation costs are asymmetrical between consumers and providers.

• Larger consumers project costs onto information providers.

• Small information provider must therefore pay disproportionate costs to their share of the commons.

The answer? 

According to the article, we need updated rules of the commons, which should be the responsibility of the network governing bodies. Large organizations also need to appreciate the limited resources of smaller organizations and make accommodations.

Ultimately, growing network governance needs to include the needs of the many, not just the most influential or vocal.

Read the full article here.

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