Maggie's Farm

The advantages you list assume that everything goes correctly. But it is likely that some percentage, lets say 5% of the records will get lost, mis-filed, lose data, not be linked or associated with specific files that directly relate, etc. The error rate and types are not too dis-similar from the manual filing system. But the primary difference will be that if a record doesn't exist or isn't retrieved properly in an automated system everyone will swear up and down it never existed. Whereas in a manual system where the people doing the actual filing and retrieval of the data are so accustomed to errors they develop a system to find misfiled and lost records. So I'm suggesting that with the automated system we will still have all the same problems and fewer solutions to those problems.

Furthermore the new automated system will cost billions, it will be delivered late, probably years even decades late, it won't work as designed, the cost overruns will be 200%-500% and the probability of it being scrapped after years of effort and lost files and system failures is about 50:50. This is the norm, the standard for very large automated systems funded by the government.

But it gets worse. To the extent the system works it will be hacked, misused and exploited. Make no mistake if you are famous or infamous everyone using the system will read your records. People will read their spouse/friends/relatives records. Information will find it's way into tabloids maybe even wikileaks.

Can't disagree with your last statement.

Probably 5% error rate is too high. Whatever the error rate I would expect it to be the same as a manual system. The problem with an automated system is people believe it. The computer says it so it must be true. A manual system is one that people intuitively understand. A misfiled record can be found placed under a first name vs the last name or in a file of a similar name or some other intuitive place that humans place things when they are talking about what they did last night. The problem with an automated system is once the data is filed or changed etc, right or wrong there is no reason "look" for it anymore. The system provides you with something when you make a query and to the user it is gospel. I'm still looking for some X-rays taken in 2003 that magically disappeared. How many X-rays disappear but we don't have a reason to discover the error? I have read that over 100,000 people die in the U.S. every year from medical mistakes. How could that possibly be true. Is that error rate 5%? Is that error rate "unacceptable"? Is it even accurate? It could be higher and unknown. Do we even know the correct error rate for existing automated systems? We ONLY know the errors discovered we don't know the unknown unknowns.

The system you describe appears to designed for "clinics" and not nations. Will it work flawlessly for 350 million people in a country where high school graduates (who would be the people entering the data) typically read at the 8th grade level?

And none of this even addresses the major flaw with such a system; the risk of misuse. China has hacked into every computer system in the free world. Israel (or someone) put a trojan into Iran's computers to destroy their nuclear bomb making systems. A bunch of thugs recently stole huge amounts of money from ATM machines around the world with a simple computer hack. How do you protect the data once it is in the system and how do you discover problems that are created in a way to prevent discovery?

I am not opposed to clinics or doctors or hospitals automating their record systems. I am opposed to the federal government mandating such a system. I am opposed to it because of the history of big government IT projects, because of what is happening right now with government misuse of power and information and because I know it will cost billions and in the end fail at some level and to some degree.