Screaming Penguin - Source Does Matter

CLEVELAND, Ohio (AP) -- President Bush said Thursday that the medical industry is behind the times, using paper and pen for many records and prescriptions when computerized records could reduce cost and errors.

"Most industries in America have used information technology to make their businesses more cost effective, more efficient and more productive. And the truth of the matter is, health care hasn't," Bush said during a forum at the Cleveland Clinic. "We've got fantastic new pharmaceuticals that help save lives, but we've got docs still writing records by hand."

The White House announced that it will propose that the federal government spend $125 million in next year's budget to test computerization of health records. The government is spending $50 million on this in the current budget year, and Bush is also asking Congress to double that amount for 2005.

The Cleveland Clinic has been helping the government develop standards for computerization and Bush heard from doctors who joined him on stage to praise the technology. The hospital uses the Internet to give patients second opinions online for cancer, heart disease and other conditions and also provides health information aimed at eliminating the time and expense of hospital visits.

Doctors also use computers to order tests and drugs, which has been shown in studies to reduce medical errors and catch patient drug allergies. Nurses use computers to track patients as they go through the hospital.

"Very impressive," Bush said as a doctor showed him a chest x-ray and other patient information on three computer screens.

But for every hospital making advancements like the Cleveland Clinic, there are many that still use the old-fashioned paper methods.

Bush campaigned on the issue last year. He said his goal is for a majority of Americans to have computerized records in 10 years.

Bush appointed Dr. David Brailer to help coordinate the move. Brailer said if Americans' lives can improve by using eBay, there are great benefits to a sort of "medical Internet" where they can retrieve their personal health care information.

Brailer said an estimated 50,000 to 100,000 people die every year from medical errors and contended that centralized data could help doctors and patients keep better track of treatment. He said while many medical records are computerized, such as lab results, drug data and even accounts of office visits in text files, they are not organized or standardized in a format that can be shared.

Brailer acknowledged great challenges to implementing a system available nationwide. All medical workers will need to have compatible technology, and converting records to such a system can be a costly hassle. Privacy and security must be ensured so that only those with patient consent have access to the records, he said.

Bush said he is sensitive to privacy concerns. "I presume I'm like most Americans. I think my medical records to be private. I don't want people looking at them, I don't want people, you know, opening them up unless I say it's fine for you to do so," he said.

Brailer said the government needs to develop incentives to get doctors online. The government has already awarded grants to encourage the transition.

"I think health care is without a doubt the last industry to go through a broad information revolution," he said. "It's a big revolutionary change to doctors."

CNN

WASHINGTON - The FBI (news - web sites)'s failure to roll out an expanded computer system that would help agents investigate criminals and terrorists is the latest in a series of costly technology blunders by government over more than a decade.

Experts blame poor planning, rapid industry advances and the massive scope of some complex projects whose price tags can run into billions of dollars at U.S. agencies with tens of thousands of employees.

"There are very few success stories," said Paul Brubaker, former deputy chief information officer at the Pentagon (news - web sites). "Failures are very common, and they've been common for a long time."

The FBI said earlier this month it might shelve its custom-built, $170 million "Virtual Case File" project because it is inadequate and outdated. The system was intended to help agents, analysts and others around the world share information without using paper or time-consuming scanning of documents.

Officials said commercial software might accomplish some of what the FBI needs.

The bureau's mess � the subject of an investigation by the Justice Department (news - web sites) and an upcoming congressional hearing � was the latest black eye among ambitious technology upgrades by the government since the 1990s.

The Internal Revenue Service (news - web sites) sought $388 million last year for its $1.7 billion "Business System Modernization" program, which congressional investigators said continues to be over budget and 15 months late. The plan will modernize the IRS systems for collecting taxes, auditing returns and helping taxpayers with questions.

The Federal Aviation Administration (news - web sites) has doubled its cost estimates to $1.69 billion for its "Standard Terminal Automation Replacement System" since 1996, according to the Transportation Department's inspector general. The new system would replace the outdated computers that control air traffic within five to 50 miles of airports.

While these are current examples, the problem has lingered for years.

"The government is just as inept in buying computers as it is in using them for accounting," declared a 1994 report, called "Computer Chaos," from a Senate Governmental Affairs subcommittee. "The system is indeed broken and it is time to fix it."

Sen. Patrick Leahy (news, bio, voting record) of Vermont, the senior Democrat on the Senate Judiciary Committee (news - web sites), called the FBI's computer overhaul "a train wreck in slow motion." Critics said the FBI's case illustrated government's propensity to build its software from scratch, which can dramatically increase a project's complexity and cost.

"They do have a tendency to reinvent the wheel," said James X. Dempsey, an expert on national security for the Center for Democracy and Technology, a Washington-based civil liberties group.

Yet some industry experts praised the FBI for its decision, saying that its potential $170 million loss paled in comparison to other government technology blunders. They also noted that FBI Director Robert Mueller acted properly to pull the plug when he realized the system wouldn't work as envisioned.

"To the FBI's credit, it could have been worse," Brubaker said. "They should build off-ramps early in the process, so if they think things are going south, they can push the reset button."

Experts note some services, such as tracking terrorists, are unique to the federal government, making it unlikely that commercial products would work without extensive modification.

"If you're in the commercial sector, there is some possibility that a packaged application might serve your purpose," said Nancy Harvey, chief executive of TenFold Corp., a small Utah-based company that builds specialized computer systems. "But it's unlikely that Robert Mueller can find an off-the-shelf product called 'Find Terrorist.' He probably has to build the application he really needs."

Harvey and others said that while government technology blunders frequently make headlines, large-scale computer upgrades in the private industry fail almost as often. But these corporate blunders aren't publicized by congressional committees, federal investigators and inspectors general, they noted.

"Ever since there's been IT (information technology), there have been problems," said Allan Holmes, Washington bureau chief for CIO, a magazine published for information executives. "The private sector struggles with this as well. It's not just ... the federal government that ... can't get it right. This is difficult."

Yahoo!

I have said it elsewhere this week, but Bush is just way off base. Aside from privacy issues, which abound, centralized medical records is a gigantic undertaking. There is a reason that technology is moving toward "Many nodes, loosely coupled": Because large systems are impossible to manage.

I can imagine a system, based on a PKI-biometric system that could hold allergy, chronic condition and medication history for people that could be a very simple, very safe system with ZERO tie to actual identity that could offer expanded ability without huge risks to the medical industry, and for less than millions and millions of dollars. I can see states expanding this system to sync data onto a smart-card style chip on your drivers license -- again, not for millions and millions of dollars, and still with minimal real risk to personal privacy.

Aside from the fact that the Bush administration can't keep a CIO or cybersecurity "czar" for more than a couple of months before they resign in protest, doesn't make me feel confident in this administration to manage a large IT project, let alone one with perhaps the most radical privacy implications of anything ever discussed.