Appification, AI, and Healthcare's New Iron Triangle

66 Pages Posted: 22 Aug 2017 Last revised: 29 Aug 2018

See all articles by Nicolas Terry

Nicolas Terry

Indiana University Robert H. McKinney School of Law

Date Written: July 14, 2018


The relationship between exponentially accelerating technologies and healthcare is simultaneously exciting, challenging, empowering, and (for some) frightening. Certainly, it has provoked numerous threads in the health law and life sciences law and policy literature. Too often, however, policymakers have tended to reduce healthcare data technology issues to oversimplified binaries (for example, data liquidity vs. life sciences). Yet, the relationships between the various healthcare stakeholders and how emerging technologies impact those relationships or the stakeholders individually are complex and multi-faceted. This complexity will only increase as healthcare assimilates not only patient-facing technologies such as medical apps but also next generation technologies such as robotics and AI. Healthcare policy choices in this “second machine age” will possess a degree of complexity that will no longer be reducible (if they ever were) to policy binaries. Indeed, for students of health law and policy, the level of complexity should bring to mind our foundational approach to discussing healthcare law and policy; the Iron Triangle of access, quality, and cost control contend that the next few decades will see us confronting multi-faceted problems that the traditional Iron Triangle does not adequately capture. Thus, I propose an additional “New,” or at least supplemental Triangle to reflect the issues that technologically-mediated healthcare and its stakeholders will be facing. This new triangle’s three points are Automation, Value, and Empathy. With this triangle, I hope to provide both an analytical lens and a sorting mechanism for working through the complex issues that will arise. The paper proceeds as follows. First, I reflect on the original Iron Triangle before introducing its young sibling, and discuss their differences, similarities, and intersections. However, just as the points of the original Iron Triangle only begin to tell the healthcare, story so Automation, Value, and Empathy are only the first layer or lens for discussion. Next, therefore, I take in order the points of the new triangle, drilling down into some of their properties, suggesting frames for analysis and themes for further study. I conclude by returning to a further comparison of the original and more recent “triangles.”

Suggested Citation

Terry, Nicolas P., Appification, AI, and Healthcare's New Iron Triangle (July 14, 2018). Journal of Health Care Law & Policy, Vol. 21, No. 2, 2018, Available at SSRN: or

Nicolas P. Terry (Contact Author)

Indiana University Robert H. McKinney School of Law ( email )

530 W. New York St
Indianapolis, IN 46202
United States

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