Most of the discussion during the Medical Banking Leadership Forum seemed to center around the idea of providing PHRs or processing transactions. The idea goes that banks should somehow get involved in the Personal Health Record (PHR) space by providing platforms for customers to view their health records since so many of their customers are used to logging in through banks. The other view is that banks are really good at processing transactions, and bank networks are secure, safe, and fast, and so healthcare transaction processing (many of these transactions being financial after all) should logically be handled by financial institutions.
I take a slightly different view. First, while I think that banks should get involved in the PHR space, I think it should be in a different capacity than simply providing a spot to store or view health data. Instead, I think that banks should instead focus on being in the identity management business, an “identity broker” if you will, and provide authentication services to any PHR vendor or hospital that might be interested. If you think about it from the PHR vendor’s perspective, their service increases in value the more confidence they can have in the validity of the identities they serve. Correctly identified accounts means you can combine them with other data sources (at the account’s request of course) so that the PHR can serve as the hub of a person’s medical data. Incorrect data is almost impossible to manage or transfer between systems, and serves to defeat the original stated purpose of a PHR. The financial services industry (read: banks) are one of the few industries that take identity management SERIOUSLY. Multiple forms of identification are required, addresses are consistently maintained, and people really care about making sure their passwords to their accounts are remembered and treated securely. Nobody types their username and password to their checking account on their monitor at work, or sends it in an email to their friend who needs it, etc.
If I were a bank, I’d use that asset (the one-time and continuous identity management) and sell it to PHR vendors (again, with the account holder’s consent). Instead of creating a new account with Google Health, let me authenticate with my Chase username and password, and everyone can feel comfortable. The PHR can now rest assured it’s got clean data, the account holder trusts Chase and has an interest in maintaining their information. As for the second prevailing view: banks are the best at financial transactions, my response is, “So what?” Maybe as some claim, everything in healthcare is a financial transaction (or should be a financial transaction) but that’s like saying lets let Visa and Mastercard determine the price of the car I’m buying. Banks already process all the financial transactions, and without in depth knowledge of the services being rendered, they’re not going to be able to price, process, or provide transparency to healthcare claims.
A lot of discussion seemed to revolve around the vein of “but we can get paid to move the data” and again, who cares? If banks really wanted to get involved in the healthcare claims adjudication process, they should invest in technology tools that provide a platform for insurance plans to define and transaction rules related to services and payments. Not a single bank in the Medical Banking Project (save for one that I talked with) has any desire to do this. The solution for banks in this area is to get closer to the details, not farther away. That’s where all the cost savings and the benefit of transparency exists anyway – at the long tail of the bell curve. Banks should know better anyway, they’ve been preaching this for years.