Unfulfilled Promises


A team of RAND researchers in 2005 published a widely cited analysis that the projected widespread adoption of health information technology could eventually save the United States more than $81 billion annually by improving the delivery and efficiency of health care

Seven years later, the evidence about the safety and efficiency of health information technology is mixed and annual health care spending has grown by $800 billion annually.


  • Health information stored in one IT system must be retrievable by others, including doctors and hospitals that are a part of other health systems. This is particularly important in emergency situations.
  • Patients should have ready access to their electronic health information, much as consumers now have access to their bank accounts.Patients should be able to view their own records and share them with health care providers of their choice.
  • Health information technology systems must be engineered to
    • aid the work of clinicians, not hinder it;
    • be intuitive, so they can be used by busy health care providers without extensive training;
    • be able to easily use systems across different health care settings, much as consumers easily drive various makes and models of automobiles.

Health Affairs

Fully interoperable, patient-centered, and easy-to-use systems are necessary but insufficient to unlock the potential of health IT. Ultimately, there is only so much that the government and vendors can do. Providers must do their part by reengineering existing processes of care to take full advantage of the efficiencies offered by health IT. This revamping of health care delivery is unlikely to happen before payment models are realigned to favor value over volume.