Health care has to move into the hi-tech age.

The last 12 months could be dubbed the international year of electronic health records, as electronic health information systems have been identified as a critical ingredient for reinvigorating health care in country after country. In his State of the Union address last year, United States President Bush set the goal of having such records for every person within 10 years. Similar initiatives are under way in almost every other developed country including Australia, Canada, Denmark, France, New Zealand and the United Kingdom. Developing countries are also beginning to take up electronic health records: in Ecuador, Kenya, Malaysia, Uganda and others, electronic systems have either been tried on a pilot basis or are planned on a nationwide scale (1–3). This awakening to the need for electronic information systems for the delivery of health care is hardly surprising and is long overdue. Consider that it is possible to travel anywhere in the world and, armed with a bank card, withdraw money from a cashpoint at any bank. Airline passengers can thank information systems for quantum leaps in aviation safety — from tracking the performance of thousands of engine parts to running decision-support systems that warn of potential problems. Nevertheless, if a patient is taken to a local hospital, emergency doctors are likely to have no idea of his medical history, which medications he takes or which tests or treatments he has had. When discharged, his family physician is unlikely to receive a discharge report, nor is there any mechanism for followup. This is why almost a third of the hospitalizations of senior citizens are the result of medication toxicity, and almost half of serious medication errors occur because clinicians do not have enough information about their patients or the drugs they are prescribing for them. Why is this happening?