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Medical StudentsThe median age of a first year medical student is 22. He or she was born in 1993, and by the time they got to 1st grade, the web was well established. In other words, they never knew a time when the Internet was not an integral part of their lives. We should not be surprised they know a lot about electronic information sharing. What do they think about electronic health records (EHRs)?

EHRs are unpopular with patients and physicians. They both want more eye contact. Doctors do not want to be data entry clerks. The EHR software is hard to use and incompatible between various providers thereby defeating the purpose. A survey of more than 1,000 medical students showed 96 percent believe improving the ability of EHR systems to access patient data from other systems is required to provide the best possible patient care (see Med Student Survey: Interoperability Most Critical to Improving Healthcare). They also confirmed the importance of improved collaboration with extended care teams.

What is obvious to the medical students should be obvious to political leaders who have refused to intervene and demand standards for EHRs. The Internet works exactly the same way everywhere in the world. Credit cards can be used anywhere in the world. EHRs cannot be easily exchanged between providers, sometimes even within the same building. It would be best if the incompatibility problem was solved through free enterprise, but it may be too late. Congress should require the 250 EHR software vendors to use compatible data formats. It should mandate standards like the Internet and credit cards.

The incompatibilities do not present a technical problem, it is a lack of health attitude. Medicare and private payers should only reimburse providers who use compatible EHRs, once they become available. It is time to stop risking patient safety and healthcare quality because of data incompatibilities. The vendors can compete on price, function, ease of use, and support so the EHRs can become more user friendly and effective. They should not be able to compete with different data formats. The medical students got it exactly right. They said improved and meaningful patient data sharing is critical to enhanced healthcare.