Healthcare and Banking

NHS leaders often make comparisons between the use of IT and digital service in banking and health. While we have much to learn from other sectors I feel this comparison means that those who make it don’t fully understand the challenge.

What banking systems do is fundamentally very simple – They move money (unambiguously and simply represented by a number and a currency) from one account to another. There are some challenges around identity assurance and security, because people don’t like to lose their money and some would quite like to steal it if they could, but basically a banking record is very simple, just look at you bank statement.

Compare this with a medical record which contains every data type known to man. Structured and coded data (based on large and complex terminologies and models of use and meaning), rich unstructured narrative text, complex numeric data, images (from a GPs sketch through photos and videos to complex imaging studies, signal data (from monitors and measuring devices) and sounds. Add to this that much of the important information is not it the data itself but in the links between them and the effect that provenance and attribution has on meaning and you have what is certainly the most complex data entity in widespread use.

Finally, consider how much the banks spend on their IT compared to the NHS and also the quality of some of the online service many of which have nothing to teach anyone about good user centred design.

So while there are things to be learnt from banking and other sectors. There are serious dangers if we don’t challenge the unfounded comparison that NHS leaders keep making between health and banking I . They are not comparable problems.

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