Dr. Benn Kosynski, PhD, from Emory University is a fascinating professor. His work has pretty much defined “inter-organizational systems” or IOS over the past two decades. The thought behind IOS is that cross-industry information technology linkage – going outside the natural boundary of one industry and into the next – yields efficiency gains for the stakeholders. Yes, it feels unnatural. Even the words are funny, like “medical banking.” But where there is real value, there is a business case and models to explore. IOS in the form of medical banking is a building block for the “eVillage” we need for sustainable healthcare systems. It is information technology’s assent that we need to work together to create something better. It is health IT’s version of 1+1=3…or even 10.
Though I hate to admit it, my study of IOS began 15 years ago. HIPAA was still incubating and there was no clarity around privacy rules. Yet, it seemed crystal clear that IOS between banking and healthcare could instigate broad innovation in an industry sorely in need of it. What I didn’t get at that time is the range of impact – it is truly extraordinary. Today, banks are abuzz about all sorts of creative innovation that will become tomorrow’s business models.
Understanding the nature of an IOS, there are a few points that need to be made about medical banking. It is not – not – a bank-centric idea. It never was. It is a collaboration of banking and healthcare systems in the form of IOS that fuels the idea and gives it strength. Perhaps the reason it seems there is so much focus on banking is because they are a new stakeholder, with new capabilities that offer new assets that can be electronically linked to improve workflow automation and other things in healthcare. In order to succeed, however, claims clearinghouses and other healthcare financial systems must be part of the picture.
Now, I know that some banks will argue and say this isn’t so. And I also get heat from our friends in the claims clearinghouse community who think we focus too much on banks. I admit, it’s a tight position to be in as we bring in the groups to collaborate, share ideas and innovate. Still, I will argue this point successfully time and time again – it truly takes an eVillage to drive efficiency. We need all parties at the table to get it done right.
IOS involves the electronic integration of adjacent industry solutions, each with core competencies that can be extended into areas that both are unfamiliar with. Some groups may try to do it all but that is the rare case. Because IOS drives real value, staying out of the eVillage progressively becomes a non-option. And while new regulations now support medical banking, like the Affordable Care Act, Section 1104, what drives IOS isn’t regulation but cost. What’s driving medical banking? It’s the realization of new value in the marketplace. That’s a moving train that can’t be stopped.
I often get asked how we are able to convene competing stakeholders, as in our G7 thought leadership platform. How do you get employers, health providers, banks, financial systems in healthcare, and health plans to the same table? Any group that has done this will tell you it isn’t easy…and all will tell you it’s absolutely necessary. Fortunately, as medical banking truly proves out, it gets easier.
IOS is not just a theory—it’s an active and vital element of business strategy. Providers and health plans, and the vendors that support them to include banking groups, must come together to form an “eVillage” that takes dollars spent inefficiently and places them into the hands of the community, our families and ourselves. We need to become very intentional about reaching beyond our corporate borders to create a caring, sharing “eVillage” that can launch our collective efforts into the healthy and sustainable communities we all want and need.