Editor's letter: Health care tipping points

The National Health Information Network must balance the fecundity and folly of today's commercial Internet

The Internet giveth, and the Internet taketh away — especially, it seems, in the health care community. Although it has expanded access to health information for millions of people, the Internet circulates dross and admits pranksters, or worse. This has dramatically raised the demand for precision — in health records,  patient identification, technology certification and treatment. That’s all well and good because it is forcing us to seek more sophisticated solutions to problems related to information growth, openness, and abundance.

But lately, the Internet scales seem to be tipping us into foreign territory and challenging the notion of what’s possible, what’s scientific and, in some cases, what’s safe.

For example, without some agreement on a national health care identification number, we may be simply too large a nation of health care consumers to expect total machine accuracy in health record matching. According to our article in this issue by senior editor Nancy Ferris, the best we can expect from the National Health Information Network is about 98 percent accuracy, and that doesn’t account for garbage-in. An error rate of more than 2 percent in  a country of 301.5 million people will create no end of headaches.

For health care providers, the Internet is bringing even more disruption. In this issue, contributing writer Brian Robinson looks into how the latest Internet techno-cultural shift — toward online collaborative communities supported by tools such as wikis, blogs and other social media technologies — might affect the health care community.

Here’s a sneak preview of Robinson’s findings: A recent British study concluded that in difficult cases, “it’s often better for doctors to google for a diagnosis.” 

That report must have raised a few eyebrows at the American Medical Association. The idea that a random Internet search could produce anything of real value in a clinical setting would seem crazy to most physicians. Yet it’s the kind of unconventional thinking that is starting to permeate U.S. businesses, government agencies and now even the health care community.

We report on other nonlinear uses of technology in this issue, including how serious games technologies are starting to influence medical education. We also report on health care executives who are using patient relationship management systems to stay “on message” with consumers.

We hope these stories will inspire your own unconventional ideas in pursuit of a better health care system.

Paul McCloskey
Government Health IT


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