The 'Expensive Interface' Blocking Medical Data Flow

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This article discusses a new challenge in medical data flow called "Cause of Death: EBIT." Beyond the previously noted problem of 'death by data protection,' it highlights a serious issue where data, though available, is blocked by high-cost business barriers—the interfaces themselves. The core critique focuses on large providers using market power to set excessive prices for components (e.g., an FHIR server) that are disproportionate to their actual development or operational costs. This structure allows them to siphon profit when customers choose competing products, making the partial service pricier than the entire package. The author argues that an interface is fundamentally a "bottleneck through which all information must pass." The control of this bottleneck functions as market dominance. Although Germany has legally mandated FHIR-based interfaces (Standard ISiK, gematik), the industry treats this legal requirement not merely as a mandate for interoperability but as a new opportunity to collect profit at the bottleneck. The solution proposed is adopting open interfaces as a core brand model and confronting the fundamental question of data ownership. The article emphasizes that true progress requires moving beyond pricing mechanisms that serve isolation rather than genuine integration or support.