If the answer to that question is No, the Committee should conduct a broader inquiry to identify the set of initiatives, related to electronic patient records, that can be completed on a wide-spread basis and have the desired effect. For the long haul, I support the vision of an electronic patient record - one that is recorded by providers at the point of care, or by the patient and their family, using uniform data standards. Such standards, together with safeguards for privacy, will facilitate access from different facilities, linkage to knowledge-bases for decision support, and aggregation to document cause and effect of clinical outcomes. Work on these standards should be a high priority, but there are a number of reasons why I feel that this work will not be sufficient to have a significant impact on the health system in the short term. Most successful standard setting efforts have involved physical systems.
Physical systems are well defined and they can be reproduced exactly.
Quality can be assured by building one factory that does the same process over and over again. A physical system can often be characterized by an equation, and an instantiation of that system might be specified with a few data points. Unlike physical systems, biological systems are inherently variable. They are compartmentalized to allow change between high and low energy states with minimal generation or consumption of heat. Each person consists of many factories, each with its own copy of genetic material, material that mutates and evolves randomly.