The bad news is that there’s still enormous resistance to these systems. At present, Maimonides Medical Center is among only 10 percent of U.S. hospitals that have implemented inpatient order-entry systems that check for errors. Most health-care entities are moving much more slowly, both because of the tremendous up-front costs (Maimonides has been spending one-third of its capital expenditures on IT) and resistance from physicians who see no reason for changing the way they practice.

CIOs are at the center of this tug-of-war. They’re the ones who must drive this transformation, delivering systems without incurring dangerous downtime or allowing medical files to fall into the wrong hands.

"The pressures in health care are such that in the next two or three years we’re going to have to achieve a new level of efficiency," says David Pecoraro, vice president and CIO of the Jewish Hospital HealthCare Services, which has installed systems similar to those at Maimonides.

"CIOs are feeling the heat."

The Problem with Paper

So what’s wrong with a medical system based on paper? To begin with, paper gets lost. Paper degrades. And no matter how voluminous, paper files are limited in the quality and quantity of data they contain.

The goal of an EMR system is to collect the data on those pieces of paper and make it dynamic. Say, for instance, a patient has diabetes. EMRs can help a doctor track how the disease has progressed over the years, without hunting through pages of scribbled medical notes.

And if the system is properly coded—if, for instance, it knows that a heart attack is the same as a myocardial infarction—it can do much more than track a patient’s progress. It can, for example, track patients in the aggregate to determine how well doctors are managing specific diseases. For instance, at Intermountain Health Care, a Salt Lake City-based insurance and health-care provider, officials can now see how many diabetics have acceptable levels of hemoglobin A1c—a key indicator of how well they (and by extension, their doctors) are coping. Now Intermountain issues a report card on individual physicians and can determine whether the organization is getting better at treating diabetes.

That’s all good, but it gets better. Once an EMR system is in place, the next step is a CPOE system. It allows a provider to request medications, lab tests and radiology procedures like CAT scans or MRIs. Ideally, the doctor gets an automatic notification about test results. But CPOEs, like EMRs, run the gamut from simple systems that do little more than computerize a prescription pad to complex ones that check for everything from decimal point errors to drug interactions and allergies to whether recent tests show that a particular medication might be contraindicated.