Healthcare IT Adoption Versus Banking Industry

I’ve often seen people compare the adoption of IT in healthcare with the banking industry’s adoption of IT. Many have wondered why the banking industry (and so many other industries) has adopted IT when healthcare is still sitting here with such low adoption levels. As I’ve thought about the difference, one thing is very clear. Both healthcare IT and banking have/had major challenges in order to implement IT in their industry. Many people have argued that healthcare IT is just more complicated or complex than other industries. There’s no doubt that healthcare IT has some unique challenges. However, I’m not sure they’re any harder than other industries. Resistance to change is a universal characteristic regardless of industry.

So, why has the banking industry adopted IT more quickly than healthcare?

I believe the major difference is that in banking the consumers demanded that banks use IT. How many of you would have gone to a bank if they didn’t provide you access to an ATM? Kind of funny to think about no? Well, ATM cards would have never been possible if it weren’t for IT. The same could be said for online banking. I know that when I moved and was searching for a new bank I wanted to make sure that it had great online banking. Luckily, now online banking is pretty much ubiquitous.

Now let’s think about healthcare. Do you choose a doctor because they use an EMR? Do consumers only go to healthcare providers who will share their patient record electronically? For the vast majority of people this just isn’t the case. Luckily, the PHR movement is going strong. Plus, the day will come when consumers demand online bill pay for their doctors. The time will come when we want to schedule appointments electronically with doctors. We’re going to demand that we get our script refills electronically. We’re going to only go to those doctors who provide e-visits. All of these things will require a great healthcare IT infrastructure and things like an EMR.

Once consumers start demanding these services, we’ll finally see the tipping point for IT adoption in healthcare.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

19 Comments

  • Anyone who looks beyond economics for why the banking industry does anything is short-sighted. John Reed, former CEO of Citigroup, created the ATM. He did it because bank teller was a relatively high-paying job, and reducing the demand for bank tellers was valuable. When Citibank first deployed ATMs, many customers refused to use them — or used them only for routine transactions while doing anything important at the teller.

    Healthcare will adopt IT when there is a compelling economic reason to do so. There still isn’t enough of one.

  • I agree that it’s economics. Keeping customers is good economics. I guess that’s one think that makes ATMs so genius. It saves the bank money and provides a great service to the end users too. The teller point is a good comment and still very instructive for healthcare IT. As you said, “Healthcare will adopt IT when there is a compelling economic reason to do so.” Nicely done.

  • As an administrator, it seems to me that healthcare has broadly adopted IT — appointment scheduling, billing, insurance eligibility, electronic claims processing, lab interfaces and more. What we are resisting, kicking and screaming, is encounter documentation. With the IT we have implemented we all have experienced at least improved efficiency, if not decreased costs. I have yet to see an electronic encounter documentation that costs less than filling out a paper form. We have had EMR for 4 years and return on the investment in physician hours for clinical customization is still years away. The most promising thing I have seen is the blue tooth pen system from Satori Labs demonstrated at the Allscripts user conference last summer. When that technology is fully available, my docs will likely dive in head first.

  • Interesting sidebar, because we’re comparing banks to medicine. In my profession as a IT infrastructure provider who works across all industries, I can say without a doubt, the financial industry is way beyond healthcare in ensuring security, availability and reliability of IT. Financial services’ data centers have seven 9’s of availability compared to hospitals, where the typical data center looks like it was cobbled together in 1984 (especially rural and non-university hospitals). Are consumers more trusting of their money than their health records or does the track record of financial services enable that trust? Availability and security are an underrated component of user acceptance.

  • Another distinction between the healthcare and banking industrys has to do with the question of who “owns” the information. It has been easier for consumers to argue that they own their financial information and have the right to access and exchange it as they choose. That argument has not been as effectively made by patients regarding their health information. In fact it has been strongly resisted by physicians and organizations who–for whatever reason–do not want to share it.

  • MPrince,
    Yes, maybe I painted a broad stroke when I said Healthcare IT and should have specified EMR. Although, even with the things you listed which seem like no brainers, many don’t have them.

    I’ve seen some standard office visits chart faster electronically than paper. Not to mention a lot of the time saved searching for the chart.

    Satori labs pen system looks interesting. I’d like to see that live. I hope that they’re at HIMSS.

  • Kristine,
    The discussion of ownership is an interesting problem. Add in the concept of patients inability to read the medical language and there’s been huge resistance to give up the records.

  • MedicalQuake,
    You’re talking about a very different subject. Medical Banking is another category from what we’re talking about in this post. This post is just comparing the adoption of IT in multiple industries.

  • John, another similarity between EHRs in healthcare and ATMs is generational comfort/resistance. Many people who were in their 50s and 60s when ATMs were introduced 25 years ago would never think of using one. They were used to standing in line inside the bank, and that is what going to the bank meant. In healthcare, the generational divide exists both on the part of patients and providers. Younger patients and providers will most certainly adapt to/adopt electronic health records sooner than older patients and providers – but it is the older folks who go to the doctor more often!

    There will come a day when electronic access to your health records will seem like that’s the way things have always been, but it will still be awhile. By the way, when I go past the bank branch in the local grocery store on a Friday afternoon, there is a long line for the teller windows, but usually no one at the two ATMs. Many people of all ages still prefer to do their banking face to human face!

  • Jim,
    Very interesting discussion. Loving it.

    I previously wrote what some considered a controversial post about the “Real Hope for EMR adoption.” In it I talked about EMR adoption being later than other industries because it takes longer for doctors to get out of medical school and into positions in practices where they can push the move to EHR along. Your point about most patients being older kind of extends this discussion along with my post above. Basically, since most patients are older, there isn’t the consumer demand for electronic interaction with doctors yet.

    Yes, some people do like face to face banking. Although, I’m not sure all the people in those lines like it. I know when an advertiser on this site pays me with a check I kind of “dread” having to deposit it. It’s a nice problem to have I know, but I’m always happy when I get a payment by PayPal even thought it costs more to process.

  • I have to agree with another commenter; the business parts of a medical practice have already broadly adopted IT and it made perfect sense for them to do so. Electronic claims and remittances alone not only save time and money for the practices, but also for the insurance companies! Until there is a compelling economic reason for widespread EMR use, the efficency gains are often balanced out by the workflow slowdowns so why adopt? Of course, that exactly what ARRA is trying to incentivize: pay doc’s to use EMR, and eventually reduce their pay if they don’t. That’s a far cry from the marketplace giving a clear, competitive reason for doctors to choose EMR. I do not see patient actively shopping for doctors based on anything more than their reputation and personal interaction; not the efficency of them getting access to their lab results online. That has nothing to do with their perception of the quality of their own medical care. I just dont see the Bank to Doctor’s office parallel holding up very well.

  • If I can add my own two cents, one item to consider is that the large proliferation of ATMs and electronic banking occurred with the larger national banks – specifically in large metropolitan areas. I think the same is the case with EHRs and EMRs. In large metropolitan areas, healthcare IT is much more advanced that most realize. For instance, I access my patient record for a patient portal at BIDMC (Boston and Massachusetts in general is leaps ahead of most areas when it comes to healthcare IT). Additionally, it is harder for single-doc and small practices to justify the costs of adoption. I liken these folks to the local bank – might not be the most technologically advanced, but certainly people you trust. In the end, I wonder out loud as to whether we will see a consolidation of the industry where larger entities scoop up practices and organizations (the MSO model comes to mind – http://wiki.galenhealthcare.com/MSO). Others thoughts?

  • Argh! You guys drive me crazy! The medical encounter is almost entirely narrative. How many bank tellers have to write down how you feel about your deposit?! The reason we don’t like to use computers is because they hinder our understanding of the patient. Not everything can be reduced to 1’s and 0’s or check boxes.

  • It is also worth mentioning that the people we are asking to foot the bill for EMR implementations are the main ones resisting the technology. Without wholesale buy-in from physicians, EMR technology won’t go anywhere. The benefits accrue to patients who may recieve better care as a result, or office staff who may be able to keep up with charts easier, or insurers and govermental bodies who will have quicker access to patient information. What’s in it for the physician? Until and unless physicians can satisfactorially answer that question for themselves, it won’t happen.

  • Amen to that Stephanie. You won’t find a bigger physician advocate than this blog. That was my initial reaction to the legislation. It doesn’t have the right motivations.

  • Hey John,

    Maybe you can do a blog on the benefits of EMR to the consumer. Right now I don’t think patients know the benefits they’ll receive if their physicians use a EMR over paper charts, which aren’t looked at after a visit until you make your next appointment. Educating the consumer on the benefits they will receive will help drive the demand.

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