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I just read a piece in CIO Magazine entitled “Health-Care Integration May Be an Expensive Prescription“. The story talks about a bill proposed by Senator Edward Kennedy which would require that hospitals, doctors’ offices and insurance companies develop systems for sharing administrative and patient data. The story says that experts in health-care IT “are leery” of backing the proposal without “proof of its ROI”. I don’t belittle the importance of ROI overall — spending money without a ROI is foolish.

On the other hand some things seem so obvious. Did companies do a ROI analysis to decide to buy a fax machine? Would a company without a web site have to do a ROI to invest in one? I believe we are about two percent of the way into what the Internet has to offer. When we get to esoteric applications then it will be time to sharpen the pencil and discriminate between investment opportunities based on ROI. I am not suggesting that prioritization isn’t important at this stage too but there are some things that businesses should be racing to do regardless of the ROI calculation. We are not even to the early stage of addressing the basics.

Every visit to a doctor starts by filling out an often poorly designed form with information that they already have, or could easily have. I occasionally send an email to my doctor. At that point it becomes paper. If he needs to send the information in my email to another consulting physician, the printed copy of my email gets faxed. Seeing so many really great web sites like eBay and Amazon makes our expectations rise every day.

How long should we have to wait before we can exchange secure email with our physician, send an instant message to the physician’s office to request a prescription refill, or have appropriate medical records transferred to a medical specialist? I can’t believe it could possibly be cheaper to have the vast amount of paperwork that we live with in health-care today than to streamline it through IT integration. Certainly the technologies are available, including digital identity technology and biometrics for authentication. Even politicians are demanding it.

Some companies will break out of the pack and show leadership. There are some encouraging signs. Empire Blue Cross and Blue Shield has engaged IBM to implement a system which will electronically read statements and rules and then automatically make payments to doctors, hospitals, and pharmacies. In another collaboration, Pfizer, Microsoft, and IBM are forming a new company to provide online services to physicians.

I don’t find myself agreeing too often with Senator Kennedy, but in this case my only disagreement is that seven years is much too long!