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John Halamka on IT Spending: When Less Is More

Financial-services providers outspend the health-care industry on information technology, but they haven't made good use of all that data

When it comes to information technology spending, I've often been told companies in the health-care industry should behave more like banks.

During the decade I've been a chief information officer, IT operating budgets have been 2% of my organization's total budget. That proportion is typical for health care. During the same period, IT budgets for the financial-services industry have averaged 10% or higher.

Given the recent troubles of AIG (AIG), Lehman Brothers, Merrill Lynch, Washington Mutual, and others, you have to wonder whether those IT budgets represent money well spent.

Of course, financial-services firms have had great systems for handling such tasks as share trading, disaster recovery, and data storage. But did they have the business-intelligence tools and dashboards that could have alerted decision makers about the looming collapse of the industry?

Too Much Data

Did the financial-services industry have controls, risk analysis, or a memory of previous crises ranging from the Depression to the Japanese banking debacle to the collapse of Enron and WorldCom? Was it greed, irrational expectations, or too much data and not enough wisdom that brought down these institutions?

We in the health-care profession naturally take no delight in the financial industry's descent. At the same time, we're trying to make the most of our IT spending and make wise choices with the data we've amassed.

One of the challenges of being a doctor in the 21st century is information overload. More medical literature is published every year than a doctor can read in a lifetime. As electronic health records become more common, doctors can be overwhelmed with data gathered about each patient. They do not want to review hundreds of normal findings; they want to know the information that can be acted on to keep patients healthy. More

John Halamka to John Casillas
: The purpose of my article was unrelated to banking or medical banking - it was to point out that we all need less data and more wisdom.  I was asked the question yesterday - what is the advantage of medical banking as compared to a fully functional PHR like Google Health?

John Casillas to John Halamka: John,Touche. Yet people arent stuffing their money under the matress, they're depositing it. They are still using ATMs, credit cards and according to the last ABA report, online banking continues to grow. For all the hazards that we've encountered in investment banking, the commercial banking side of the house is operating as its always been, 24x7. Today, people still trust their banks to access the money instantaneously all over the world. We should not throw the baby out with the bath water. Most people, even and especially the uninsured, seek the ER when they are sick. Is the health care system broken? Yes. Do people still rely on it when they get sick. Yes. In medical banking, we find ourselves linking two broken systems - systems that represent the health and wealth of peoples and nations. Both have the potential to fundamentally transform our lives for the better. Linking tremendous investments in IT in banking to optimize healthcare isnt only good thinking, its actively being persued by mutiple muti-nationals and other companies - even governments. Needless to say, I wouldnt be too quick to erase the high levels of automation acheived in banking from my website or resume. Those levels of automation have produced outstanding improvements in how we manage our money today. And they will continue to do so as medical banking, mobile banking and even micro-banking evolve in the marketplace. Bottom line: our message is still the same. Banking systems have enormous potential to improve healthcare. And we have an historic opportunity to make this happen for our world, for our families. -from vacation in sunny California

Ed Dodds to John Casillas and John Halamka
: Diebold ATMs infected with credit card skimming malware at ZDNet

March 20, 2009 in A Bank-Driven eHealth Ecosystem | Permalink


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