1993: President Bill Clinton proposes a major healthcare reform plan, including a medical ID card, but it isn't enacted.
1997: The Health Insurance Portability and Accountability Act requires privacy and security safeguards for health records.
1999: Healthcare facilities scramble to prepare their systems for the Y2K date rollover.
2004: President George W. Bush sets a goal to make electronic health records available to most Americans in the next 10 years.
2009: Federal economic stimulus legislation encourages the adoption and "meaningful use" of electronic health records.
2009: A report by the Institute of Medicine urges the healthcare industry to increase its focus on using IT to improve clinical decision-making.
2010: President Barack Obama signs healthcare reform legislation that has numerous provisions affecting IT.
-- Mitch Betts
It may be 10 or 15 years before data sharing is widespread, because it's "a lot harder to achieve than most people appreciate," says Peter Gabriel, director of informatics at the University of Pennsylvania School of Medicine's Department of Radiation Oncology.
One looming issue is whether people will trust that their electronic medical records will be secure and private while all this data sharing goes on. Polls show that consumers are concerned that employers and marketers might gain access to their health records, for example.
The counterargument is that electronic records can be more secure than paper ones. Many computerized health record systems already use multilevel access controls that can limit who can view specific information, and some provide audit trails that show who accessed what details when.
But still unresolved are questions about how patients' records will be handled -- and how they want their records handled. Should they be able to opt into a system of shared electronic records, or should they have to opt out? And who will be the owners and custodians of the information -- the patients themselves, or the caregivers or facilities that created the data?
Will IT Cut Medical Costs?
Healthcare IT professionals expect that technology will not only improve patient care, but also deliver savings, by streamlining processes and eliminating costly mistakes. "We have known since at the least the 1990s that the highest-quality care results in the lowest-cost care," says Aaron Seib, CEO of the National eHealth Collaborative, a public-private partnership promoting a nationwide health information system.