Dr. Elliot King

In so many areas, the impact of computerization is now taken for granted. Foreign travelers expect that they can shove their ATM card into a machine anywhere in the world and money will pop out in seconds. Nobody thinks about all the processing that takes place to get that done. Ask an online search engine just about any question and it will produce an answer—though not always a correct answer—in a flash. And if you want to sort through terabytes of corporate data to identify trends or other insights—no problem. That is what Business Intelligence does. And, hey, you can Skype with somebody sitting halfway around the world for free.

But with all the tremendous technology gains made in so many areas, healthcare remains stubbornly resistant to successful breakthroughs in automation. And this matters. Not only did healthcare represent more than 17 percent of the U.S. economy in 2009, by 2020 healthcare spending may account for as much as 20 percent of economic activity in the United States. 

But there is more than just dollars involved in this issue. Healthcare impacts real people and the lack of automation hurts individual care. You know the drill. You go from one specialist to another, filling out a new personal history each time. Your complete health records aren’t accessible to your authorized caregivers. And you can never get a copy of your latest records. Sharing electronic medical records among doctors would reduce medical errors and enable more efficient testing and treatment. This has become a significant initiative at IBM and other major computer vendors; spawning the VNA Institute of Technology and a whole host of web resources.

The lack of benefits of cutting-edge information technology is not due to the lack of trying. Since the early 1980s, efforts to standardize medical imaging data protocols like DICOM, the current standard, have attempted to facilitate the sharing of this information among different computer systems. And the Federal government and others have been investing heavily in the development of electronic medical records for the past six decades.

The real problem is that medical information is just so complex. Information is flowing in from all sorts of places and in all sorts of formats. Much of the information is image data taken with different devices, viewed in different ways and associated with different metadata. As you can imagine, it is a challenge to be able to store and access everything from everywhere.

One new approach to this problem is being called a vendor neutral archive (VNA). This is a kind of virtual Switzerland for medical information. A vendor neutral archive creates a shared institutional archive for clinical image data. As with many new buzzwords, different people have different definitions for a vendor neutral archive. But the bottom line is this: the healthcare system is fragmented and disjointed. And at some point, the database formats for its information system can’t be. If you haven’t heard of the high priority of healthcare IT systems in the government, you soon will.

Image contributed by Stuart Miles

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