At first, bioterrorism—whether it’s inhalation anthrax, smallpox, pneumonic plague or something else entirely—will probably feel like the flu. You’ll be miserable, but you probably won’t be alarmed. You’ll go to your local drugstore, clinic, maybe an emergency room. Doctors in one place or another might notice a small uptick in flu-like symptoms. But no one will see the pattern. Until the dying starts.

Unless, of course, a sophisticated IT network could transmit and integrate all that data in real-time so that health officials could see what was happening across hundreds, if not thousands, of facilities. And that’s just what legions of technologists and clinicians in public health departments, hospitals, laboratories and pharmacies are trying to develop right now.

"The systems are being defined and created as we speak," says Rosemary Nelson, chairman of National Preparedness and Response, a new bioterrorism task force created by the Healthcare Information Management and Systems Society (HIMSS). If such a network existed, health officials could sound the alarm in that precariously short window of time when the spread of the disease could be stopped.

This kind of system could be IT’s greatest success, saving lives as well as money. Even without a bioterror attack, a surveillance system would be useful in detecting the early stages of any disease, such as the recent outbreak of the mysterious ailment called SARS, or severe acute respiratory syndrome.

Such a system could also help lay the groundwork for a long-desired system of standardized electronic medical records, which would significantly reduce errors in patient care and save substantial sums of time and money.

But if the pieces don’t come together—or if they do but in the process erode the concept of patient confidentiality—then that could also be IT’s biggest failure.

"IT has so much potential use in bioterrorism and health care, but the word is potential," says Dr. Eduardo Ortiz, a senior fellow with the

Agency for Health Care Research and Quality at the U.S. Department of Health and Human Services, which last August released a 354-page report about how IT could be used for bioterrorism preparedness and response. "We’re not there yet; we’re not even close."

Since the anthrax attacks in Connecticut, Florida, New York and Washington, D.C., definite progress has been made in creating an effective early warning system for bioterrorism. But wildly disparate computer systems, disconnected and often overlapping projects, and a lack of industry standards still stand in the way of creating the kind of network that can save lives.