Modernizing the management of health records

The U.S. health-care system exchanges tens of millions of patient records a day. Thanks to recent technological advances, the ability to analyze such large amounts of data has improved markedly.

Why, then, are patients still filling out clipboards of redundant information, or juggling multiple passwords and portals to make a doctor’s appointment?

Over the past decade and a half, the government has spent more than $35 billion attempting to modernize health data-sharing. Yet the typical patient experience has hardly improved. Designing a saner, more user-friendly system isn’t only a matter of convenience; it should improve care, boost efficiency and lay the groundwork for technological advances to come.

The earliest medical-records systems started in academic centers in the 1960s and ’70s. A “health IT” sector emerged about a decade later. By the early 2000s, a series of reports suggested the myriad benefits of digital records—from increased legibility to quicker access—would reduce medical errors and save lives.

President Barack Obama soon became an evangelist for this effort. “We will make sure that every doctor’s office and hospital in this country is using cutting-edge technology and electronic medical records,” he said in 2008, just before taking office. Two months later, Congress passed a fatefully ambitious law to accelerate the digitization of health data, largely through incentive payments to providers that shuttled generous subsidies to vendors.

You might guess what happened next. Anxious to meet the subsidy deadlines and avoid penalties, providers adopted what software was available. Inferior products—developed hastily, with little thought for patient safety and user experience—became an entrenched and detested feature of medical practice.

Lawmakers, once dazzled by the notion of data beaming between nodes of an interconnected health-care system, eventually realized they’d overlooked the industry’s disincentives to share lucrative patient information with their competitors.

By then, the money was spent and providers were locked into an immature technology that frustrates patients and infuriates doctors. More than 70% of hospitals report challenges with exchanging data across vendors, and 57% say they struggle to identify the correct patient.

Although almost all hospitals say they’re able to offer electronic medical records, more than a fifth of patients haven’t accessed their data within the past year. Meanwhile, many providers, especially in poorer areas, aren’t digitized at all. Just 13% of family-medicine physicians say information in their electronic health-records system is easy to find and use.

Fixing this dysfunction won’t be easy. Many hospital executives have concluded that finding a new vendor isn’t worth the cost or uncertainty. For providers who participate in Medicare, incentive payments are still tied to a litany of data-sharing requirements. (Those unsure about their qualifications can consult an “eligibility decision tree.”) For all their flaws, the biggest electronic-records vendors deliver a product that reliably checks the boxes and sends the bills.

Even so, progress is still possible. A public-private effort to remove data-sharing impediments was launched in 2022. Last year, a large vendor announced it would allow patients to share their health data with other apps. In theory, that should make it easier for a patient visiting a new doctor to preload personal information, insurance details and past records, as well as remove some of the waiting-room drudgery.

It will also enable patients to upload records to artificial-intelligence tools for a “second opinion” or plain-English explanations of their diagnoses, which are becoming remarkably accurate.

If companies want consumers to use such products, they’ll need to demonstrate they’re serious about patient privacy and data security. Record-sharing alerts, similar to bank-transfer notifications, would be a good start.

Congress should likewise clarify how existing privacy and liability laws apply to these new applications. It should also fund basic research to determine how the use of electronic records improves health outcomes—which is, after all, the point.

The gap between the maddening inefficiencies and potential benefits of electronic health records is narrower than it may seem. With the right reforms, the American health-care business may yet enter the 21st century.

2025 Bloomberg L.P. Distributed by Tribune Content Agency, LLC.