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Frontiers of Engineering Reports on Leading-Edge Engineering from the 2009 Symposium (2010) / Chapter Skim
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Why Health Information Technology Doesn't Work--Elmer V. Bernstam and Todd R. Johnson
Pages 81-90

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From page 81...
... -- Barack Obama George Mason University, January 8, 2009 Widespread dissatisfaction with health care in America and rapid advancements in information technology have focused attention on information technol ogy, which has dramatically improved efficiency and safety in other industries, as an obvious part of the solution to our health care woes. However, there is increasing evidence that the adoption of health information technology (HIT)
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From page 82...
... To this day, the fundamental problem of context and meaning remains unsolved, making disambiguation difficult and resulting in some amusing failures. Anecdotal examples include: "The spirit is willing, but the flesh is weak" was translated from English  Russian  English as "The vodka is good, but the meat is rotten," and "out of sight, out of mind" came out as "blind idiot." In 1966, the influential Automatic Language Processing Advisory Committee (ALPAC)
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From page 83...
... THE SEMANTIC GAP Loosely speaking, philosophers who study information draw a distinction between data (syntax) and information, defined as meaningful data (i.e., data + meaning or, alternatively syntax + semantics)
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From page 84...
... Even though these symbols abstract away the rich semantic complexity of the balance, such as its current purchasing power or that the money can be used to purchase goods and services, this is of no consequence to the successful automation of bank accounts. Thus data-manipulating machines (IT)
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From page 85...
... There are many barriers to the adoption of HIT. Hospitals that have not implemented electronic medical records most frequently cite financial concerns, including the lack of adequate capital for purchasing equipment (74 percent)
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From page 86...
... A third research challenge is to evaluate HIT as a clinical intervention. An instructive example is that a commercial electronic health record was associated with increased mortality at one institution (Han et al., 2005)
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From page 87...
... In contrast, unique patient identifiers in other countries have greatly facilitated clinical research. Similarly, the high cost of health care in the United States encourages "medi cal tourism." Many Americans travel abroad for care that is too expensive for them to obtain in the United States (Wapner, 2008)
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From page 88...
... 2005. Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system.
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From page 89...
... 2008. American Medical Association provides guidance on medical tourism.
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Key Terms

  • medical informatics
  • informatics association
  • health data
  • medical concepts
  • banking data

  • order entry
  • automated translation
  • research challenge
  • joint commission
  • increased mortality

  • improve health
  • electronic health
  • care information
  • data technology
  • care data

  • medical errors
  • bank accounts
  • clinical trials
  • semantic gap
  • russian communications

  • physician order
  • privacy concerns
  • meaningful data
  • personal digital
  • concepts relevant

  • research challenges
  • computerized physician
  • computerised health
  • cautioning health
  • health record


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