With your medical records in paper form and scattered across the offices of various practitioners, the people treating you when you need those records most--when you're lying on a gurney in the emergency room, say--may have no idea what to do. Sometimes they do the wrong thing: in the United States, an estimated 98,000 deaths occur annually from medical mistakes, and 1.5 million people suffer from adverse drug interactions, incorrect doses, and other medication errors. Many of these deaths and injuries could be avoided if the full medical records of patients were available to their treating physicians.

Decades after virtually every significant enterprise in the developed world turned to computers to keep records, computers still remain astonishingly underutilized in medicine, their use suppressed by financial, sociological, and political issues--and the sheer complexity of the automation challenge. After a history of false starts, a comprehensive system of electronic health records linking hospitals, general practitioners, specialists, insurance offices, and others could debut in the United States within a decade. The National Health Information Network, as it's called, will replace paper-based files with a digital record containing your complete medical history, which your health-care provider will be able to access almost instantaneously wherever you seek treatment.

The potential advantages are enormous: having a cradle-to-grave view of a patient will allow doctors to focus on preventive care, rather than on just treating diseases. For employers, insurance companies, and the government, electronic medical records promise to help reduce skyrocketing health-care costs, which now come to US $1.9 trillion, or about 16 percent of gross domestic product.

To date, though, no country has ever built a fully operational electronic health record system, and the hurdles to doing so are huge. One recent study placed the projected cost for a U.S. system at $276 billlion--more than three times what's been spent on creating a missile defense system over the past 20 years. The many technical, social, and political issues are also formidable. Given the far-reaching impact such a system would have on the well-being of every citizen, a failure would be profound. Unfortunately, as an article by Robert Charette in the October 2006 issue of IEEE Spectrum discusses, signs already suggest that the U.S. effort will be more complicated, more expensive, and will take a much longer time to implement than is now officially projected.



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