Tragedy of Anticommons in Digital Right Management of Medical Records

The challenge of moving a decentralized, fragmented, paper-based healthcare system to an interconnected, automated, networked world is not merely technological. Digital right management (DRM) technologies can be leveraged as a tool to protect the privacy of electronic health records (EHRs) via encryption, access control, etc. However, the deployment of DRM technology needs to address special requirements for the healthcare system. One of the critical issues is that there is no clearly defined data ownership, and multiple parties own different pieces of a patient’s medical history. The fractured ownership of medical information among medical service providers and insurers has created the tragedy of anticommons for implementation of DRMs. In this work, we investigate DRM under multiple ownerships of medical data, and employ game-theoretic tools to study and understand the strategic behaviors of different owners in the healthcare system. Our approach aims to address the underutilization of EHR resources, and provides a theoretical basis for mechanism design of economic policies to improve social welfare and efficiency of the electronic healthcare system.