With the well past due retirement of America Online’s Instant Messenger, I thought about  interconnectivity concerns in light of AOL’s market dominance.  Years ago, advocates worried that AOL could bolster its market share simply by refusing to interconnect its networks and large subscriber base with market entrants.  The AOL-Time Warner merger provided a basis for the federal government to impose some connectivity requirements that in retrospect appear unnecessary.

          Currently, I am experiencing the consequences when health networks do not interconnect and no government agency has legal authority, or the inclination to require connectivity.  My Primary Care Physician and all specialty doctors I see have an affiliation with Medical Practice Group One.  This Group is affiliated with the only hospital in town.  My employer has its own Medical Practice Group Two which predictably cannot share medical information, including blood tests, with other Groups.  Additionally, my employer has negotiated quite attractive blood test prices with an unaffiliated Large Diagnostic Facility which predictably has no direct document links with either Medical Practice Groups.

          In this “balkanized” environment, test results do not get delivered to physicians and the Medical Practice Groups cannot share results.  With repeated prodding, the Large Diagnostic Facility will use 1960s facsimile technology to send results to the Medical Practice Groups.

          I can reduce, if not eliminate the prospects for non-delivery of results if I opt to use the Local Diagnostic Facility affiliated with both the local hospital and Medical Practice Group One.  This option typically costs 300-400 percent more.

          Would you pay the premium to reduce or eliminate hassles, uncertainty and anxiety?  For many months I resisted and have paid the consequences.  However, I cannot help thinking that intentional “unconnectivity” serves business interests at the expense of consumers.  Economists can explain the situation in terms of network effects and externalities, but they do not seem to factor in higher consumer costs for joining the dominant network.