Why Doctors Still Use Pen And Paper

A Q&A with David Blumenthal, a physician and former Harvard Medical School professor. The health-care system is one of the most technology-dependent parts of the American economy, and one of the most primitive. Every patient knows, and dreads, the first stage of any doctor visit: sitting down with a clipboard and filling out forms by hand.

Blumenthal was from 2009 to 2011 the national coordinator for health information technology, in charge of modernizing the nation’s medical-records systems. He now directs The Commonwealth Fund, a foundation that conducts health-policy research. Here, he talks about why progress has been so slow, and when and how that might change.

“From the patient’s perspective, this is a no-brainer,” he said. “The benefits are substantial. But from the provider’s perspective, there are substantial costs in setting up and using the systems. Until now, providers haven’t recovered those costs, either in payment or in increased satisfaction, or in any other way. Ultimately, there are of course benefits to the professional as well. It’s beyond question that you become a better physician, a better nurse, a better manager when you have the digital data at your fingertips. But the costs are considerable, and they have fallen on people who have no economic incentive to make the transition.”

Asked in the broadest sense, what difference will better information technology make in health, Blumenthal responded: “Fundamentally, every medical record is a tool for collecting information: the information a physician collects when looking at you in a physical examination; the results of lab tests. The constant automatic information collection is going to increase, whether it’s your phone monitoring your heart rate or your scale sending information about your weight to your health provider, or the contact lenses Google wants to market that measure blood glucose levels.”