Regarding the April 20 Q&A, “Healthcare should emulate banks on IT interoperability” (p. 30), I spent 25 years as a chief information officer in the financial services industry, and I agree with the comment about technology interoperability.
In 1853, banks formed the Clearing House, an association that standardized and performed transactions among members. In 1974, the National Automated Clearing House Association was formed. By 1978, banks across the U.S. were exchanging electronic payments (in part because of the regulatory framework of the Electronic Fund Transfer Act of 1978). In 2013, 22 billion transactions ($39 trillion) were exchanged via the ACH network.
One might argue that banking transactions are simpler than healthcare transactions, but the clearing and settlement of stocks, bonds and commodities are among the most complex, high-volume, secure inter-organizational processes performed in any industry. The Securities and Exchange Commission and the Commodity Futures Trading Commission are empowered to create and enforce the rules that member organizations must follow. In 2010, the settled value of stocks alone was $60 trillion.
The analogies are appropriate. Financial services have been securely exchanging complex, real-time transactions for decades. The lessons we learned and the mistakes we made would be valuable for healthcare.
