[MUSIC] Hi, this is Bruce Darrow and I'm going to be talking about the things that make information technology easy historically in this country. Starting in the 20th century, there were a lot of industries where it made sense for there to be early adoption of information technology, and healthcare was not one of those. But if we look back at the ones that were early adopters, we might see some themes that would be helpful in terms of figuring out where the technical challenges are going to be in healthcare. One of the fields where it was early adoption for technology, was the banking industry. This was a case where it was very easy for banks to keep electronic records of how much money you did or didn't have in the bank the rates of loan percentages and interest, and to pass this information back and forth between banks. A second area where there was early adoption of IT in this country was the insurance enterprise. Which was a way of taking insurance policy information, using actuarial tables, calculating what the policy values would be and the premiums would be and being able to share this information without geographical boundaries. A third place where there was early adoption technology, is the aviation industry. The heavy use of technology in the airplanes themselves as well as the air traffic control requirements made early adoption of IT necessary to provide safe flights for the industry. If we think about examples where there was neither early adoption nor necessarily adoption today some of the fields in which you don't see heavy use of IT are for example law. In the legal profession it's appropriate for some records to be kept secure. You don't necessarily want lawyer one sharing information with lawyer two. So as a lawyer, even today, it is possible to have a practice where the majority of your work is done on paper. There is no industry wide standard for document sharing beyond the document types that are common to word processors and other systems like that. Another one where you might think is an area where there isn't as much use of information technology is home repair. If you think about the work that your contractor does or an electrician or plumber does, there isn't really necessarily a reason for that information to be passed along or shared to somebody else. Your plumber doesn't need to reference your electrician's records if they are doing repair some years later. There's no real need for interoperability or anything else like that. And so, this is a field where there isn't much need for information technology as a bedrock for the practice of the profession. A third one is your standard arts or crafts small business person. There may be the use of technology in either the selling or ordering of their equipment or their product, they may use technology in making their product. But there's no real platform and many people in small business doing arts and crafts can do so on sort of a shoestring type of IT setup. So, when you look at these different examples, what you see is, some of the factors that would drive the early adoption of information technology include the necessity of having the information available at any time in any location. For example in the banking industry, if you're bank is in New York and you want to withdraw money in California. Having the information technology to be able to do that transaction at 1 in the morning is essential. You don't want to be in a position where somebody at the bank in California is getting on the phone with somebody in New York to verify your account information and your balance in order for that transaction to go through. Another example of that is insurance claims. Chances are if you're going to have a car accident, you might not be in the vicinity of your insurance agent's office at that time. So there's the need to be able to access insurance claim records and information, and policy information 24 hours a day, 7 days a week, regardless of your location. So the ability to get on demand access to information drives the use of IT. And in both of these cases there is a value apparent in the industry. So it was in the interest of the banking industry, in the interest of the insurance industry to be able to provide these on demand services. And so there was a strong drive within them to be able to use information technology for their aims. So when you think about the factors that make adoption of IT easy for the industry, here are some of the things that you would consider. First of all, there have to be standards for the information. So for example, in the insurance business you need to have a standard for what the duration and coverage of a policy would be. You can't have multiple definitions of this, you need to have the standard of what money is in the banking industry. You can't have two definitions of $1. $1 has to be $1 at bank A and at bank B. So, the standards for exchange of information have to exist. Second of all, it's helpful with the scenarios are limited. When you are looking at the banking industry and you're looking at ATMs, there are only so many things that you can do at an ATM. You can withdraw money, you can deposit money, you can transfer money. But the number of functions that you can do at any ATM are going to be limited and discrete. You don't go to the ATM and free wheel. You don't say okay, today I think I want to change my euros into Australian dollars. That's not a feature that is supported at the majority of ATMs, and so by limiting the complexity, limiting the scenarios, you make it possible for the technology to be adopted sooner and easier. The third thing is that there are a few interdependencies. One of the limiters of information technology is the possibility that you might have to depend on something outside of the system that you're in. So for example, if in the banking industry you had to be able to calculate the rate of insurance on something outside of the industry, the phases of the moon or the level of the tides or something like that. You would have to be able to build the ability to reference that information into your system. The lack of interdependency makes it easier to adopt the IT. And then finally, one of the strong drivers is the return on investment. So, if it is profitable to be able to offer your banking customers the ability to take out money wherever they are. If it is an industry standard to be able to do so or if it's a market advantage to be able to do so. Then, you will put in the money to invest in that technology because it will pay off in your bottom line. So, these are some of the factors that make IT easy to adopt, and in the subsequent presentations, I'll talk about what makes health IT somewhat harder to adopt. [MUSIC]
