The proposal, which would allow medical providers and private companies to share patient data more freely, has a laudable aim: to break down long-standing silos and speed the transition to AI-driven healthcare. In principle, that’s good news. Sixty companies have already signed on, including Amazon, Apple, and Google. Under the program, a company like Apple could, in theory, tap into health records and wellness data from other participants, such as weight-loss and fitness service Noom. That could give tech giants unprecedented access to people’s daily habits, what they eat, how often they exercise, even how much sleep they get.
I believe that AI can deliver enormous gains for global healthcare over the next decade. And yes, I’m biased. But when healthcare systems centralize their data, it can improve the models that automate administrative tasks, enhance clinical procedures, and ultimately improve patient outcomes.
Trump’s plan could help knit together America’s fractured private health system. A Mayo Clinic in Phoenix should be able to access a patient’s records from a medical center in Tucson without friction. The current fragmentation delays treatment, leads to inaccurate diagnoses, and can sometimes cause preventable errors.
But enlisting Big Tech to steward this data could backfire. The US risks re-siloing information, this time in the hands of a few dominant corporations, creating a ‘health data oligopoly’ that stifles innovation, compromises privacy, and pushes smaller players out of the market. We’ve seen this movie before. Apple and Microsoft dominate personal computing, and Google controls nearly 90% of global search. In each case, market leaders used scale to acquire rivals and vacuum up user data. We cannot allow the same pattern with patient information.
If platform giants become the gatekeepers, access could be locked behind proprietary pipes and opaque terms. Startups are where much of the sector’s real innovation happens and they would get squeezed. BetterHelp has connected millions to mental health services via its app. Gabbi uses predictive analytics to assess breast cancer risks. These companies, along with countless others, often depend on pilot projects and data-sharing partnerships with hospitals and universities to develop and refine their products. My own company, Rhazes AI, has benefitted significantly from the use of real patient data through partnerships with public and academic bodies.
US startups have flourished in similar ecosystems. Spring Health, now a unicorn mental health platform, launched its pre-seed trials using data from large antidepressant clinical trials. If Trump’s plan makes Big Tech the primary gatekeeper of health data, these opportunities could dry up. And at a time when America faces rising rates of chronic disease, an aging workforce, and a shortage of frontline nurses, we need fresh ideas and disruptive technologies more than ever.
A better model would be to keep healthcare providers as primary custodians, with data anonymized for research and innovation. That approach best protects privacy and market fairness.
The UK’s Our Future Health project aims to catalyze research into diseases, and once completed, will give health researchers access to a biobank of five million blood samples. The NHS-partnered project imposes tight safeguards to patient privacy, including ‘airlocking’ data within a database so it can’t be freely exported. It’s only right that large-scale databases are leveraged for public good – not financial gain. And crucially, companies will have the same access privileges, whether they’re a fledgling firm or a tech titan.
Similarly, if a doctor transcribes a private consultation about substance abuse or mental health, patients expect that information to stay within the provider’s records. Giving it to Big Tech risks eroding that trust.
Some critics argue that medical providers can’t be trusted to safeguard sensitive data, and they have a point. Earlier this year, a massive breach exposed the personal healthcare data of Connecticut residents, including Social Security numbers and medical details. The UK’s NHS has suffered cyberattacks, including one linked to a patient death. But the answer is not to offload this responsibility to corporate giants. Governments should invest in hospital cybersecurity, not hand the keys to companies whose business models rely on monetizing data.
The Trump administration says it wants to free up siloed data, but it risks building new silos with shinier branding. Entrusting big tech firms to control health information could stifle innovation, compromise privacy, and edge out smaller health tech players, the very companies driving real, equitable advances throughout America’s health system. The path forward is clear: provider‑led custodianship, interoperability under open standards, equal access, rigorous auditability, and privacy by design. That is how to catalyze AI‑enabled healthcare while protecting competition, trust and, above all, patients.
Editor’s note: Neither the author nor his company have any relationship with the companies/products mentioned.
Photo: from2015, Getty Images
Dr. Zaid Al-Fagih is the Co-Founder and CEO of Rhazes AI, an award-winning AI-powered virtual assistant. The tool empowers doctors by boosting clinical productivity, reducing medical errors and burnout, and restoring the human connection in medicine. Prior to founding Rhazes AI, Dr Al-Fagih practiced full-time as a medical doctor in the NHS, and was a voluntary first responder and first aid trainer on humanitarian missions during the Syrian conflict. He has published research in leading journals on applying emerging technologies to healthcare, most recently in the Emergency Medical Journal.
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