This time last year, I published a blog and a video on Linkedin to coincide with the 50th anniversary of the opening of the first ATM in the London borough of Enfield at a branch of Barclays. It was an event that was to change banking forever.

Digital Transformation was in progress decades before the phrase had been invented. The recent publication of the NCUB paper ‘The Human Factor’ seems an appropriate time to explore the idea once again since the ATM was all about putting the human in control.

Today there are 3 million ATMs worldwide, with over 200 different transactions available 24/7 – we can’t imagine a world where it doesn’t exist. When it was invented, no-one knew they needed it and, far less, believed they would come to rely on it. Almost from the moment the first ATM went live, fear and cynicism dropped away, and it rapidly became the normal way of getting cash.

The ATM Industry Association talks about the ATM moment as “changing the way we think and behave, both as individuals and as a society, putting us in control of our cash for the first time.”

I’ve worked around healthcare for the best part of 30 years – 13 of those employed in various IT roles at Barts and the London (now Barts Healthcare Trust). I’ve long thought that healthcare needs its own “ATM moment”.

This time last year, I spoke about the Personal Health Record being the catalyst for the ATM moment in Health. A year later, I’m reflecting on the fact that it’s only part of the story. A personal health record is a system of record (clue’s in the name). For true transformation in health and care we need insights and engagement, and above all, trust.

Trust was one of a number of features that made the ATM such a catalyst for change. Gaining access to an ATM requires strong identity based on chip and pin which is supported by a highly complex technology infrastructure and multiple trust agreements between banking organisations. All that infrastructure gives us our expected 24×7 access, and crucially, control of our money. The banking ATM moment enabled change, ATMs quickly evolved to support 200+ transactions, all of which previously required a bank clerk. It became the precursor to Internet Banking by engendering trust. No single company held a monopoly over the technology – multiple vendors somehow managed to make sure that the messages flowed, and people got their money. How can we create the same experience in health and care?

After a year’s reflection, healthcare’s ATM moment will come when we have a trusted network in which we can share and transact information that we care about, just as we care about our money and yet entrust it to a hole in the wall.

To qualify as an ATM Moment, it has to involve on of the most important “Human Factors” – Control. I need to be sure that my healthcare information is correct and easy, yet safe to share.

We’ve made a start with Personal Health Records, maybe when we look back we’ll see it as a foundation. We have the Red Book, a child health record that starts at birth – making it possible for mums and dads to interact with the record from a smart phone. The birth of a baby is a great starting point for the creation of a digital record for every individual.

But there’s more. Technology marches on at a pace. When the Tabloids start to talk about AI, you know it’s mainstream! At the same time, the Banking industry is adopting the very technology that threatens its existence – cryptocurrencies that don’t require a central clearing service. Barclays, 50 or so years after leading in ATMs is one of the first banks to embrace Bitcoin, the leading cryptocurrency.

I believe that the key to the ATM moment in health is Trust. On the day that GDPR comes into being, we need a trusted network that transcends any single organisation and gives people the confidence that they are in control, knowing that their data will be handled at least as securely as their cash.

How do we engender trust whilst giving control? Not through yet another centralised, hierarchical system – but through a technology that is distributed and owned by no one and everyone. A place where I am in control of my data and who can see it. We can do this through the same technology that underpins cryptocurrencies such as Bitcoin. As stated in Lord Holmes report on Blockchain published last year, Distributed Ledger Technologies (the technology that underpins bitcoin) has the potential to “provide a fully auditable record, facilitating GDPR compliance by putting the end user in control of their own data.”

Just as the banking industry is facing another revolution, another ATM Moment, based on cryptocurrencies, maybe that same technology will engender the ATM Moment in Healthcare. I’ll be blogging more about this as things develop.


By Paul Thomas, Digital Advisor, Microsoft