The Economist writes about the “failure of the health-care industry worldwide to adopt modern information technology.”
The solution seems obvious: to get all the information about patients out of paper files and into electronic databases thatand this is the crucial pointcan connect to one another so that any doctor can access all the information that he needs to help any given patient at any time in any place. In other words, the solution is not merely to use computers, but to link the systems of doctors, hospitals, laboratories, pharmacies and insurers, thus making them, in the jargon, interoperable.
This may be obvious, but today it is also a very distant goal. According to David Bates, the head of general medicine at Boston’s Brigham and Women’s Hospital and an expert on the use of IT in health care, the industry invests only about 2% of its revenues in IT, compared with 10% for other information-intensive industries. Superficially, there are big differences between countries. In Britain, 98% of general practitioners have computers somewhere in their offices, and 30% claim to be paperless, whereas in America 95% of small practices use only pen and paper. But, says Mr Bates, this obscures the larger point, which is that even the IT systems that do exist cannot talk to those of other providers, and so are not all that useful.
As the Markle Foundation puts it, the technology must be designed in such a way that decisions about linking and sharing are made at the edges of the network by patients in consultation with their doctors, and never inside the network. This goes to the very heart of the matter. For even though it is fine to start hoping for the day when interoperable electronic health records create vast pools of medical information that could be used to find new cures and battle epidemics in real time, their ultimate purpose is to make one simple and shockingly overdue change: to enable individuals, at last, to have access to, and possession of, information about their own health.
