Monday, May 15, 2006


Computerizing Pupils and Patients

The 15 May 2006 New York Times has a story titled "States Struggle to Computerize School Records" that reminded me of a post I made here a couple of months ago about electronic health records. Many states are trying to create a composite view of all the information about their public school students, including their courses, grades, test scores, attendance, disciplinary actions – all linked by a unique tracking number. Many of the efforts have failed to meet their functional, performance, usability, or budget requirements and for all the usual reasons.

Most large computerization projects are complex and challenging. But building a data system to collect information from all the schools in a state can be extraordinarily daunting, involving the integration of computer systems used in hundreds of districts, each of which may have multiple databases using distinct operating systems.

The only cause of failure unique to school systems seems to be that many of them simply lack the technological and process maturity to attempt this integration but have been forced to take it on by the No Child Left Behind Act of 2001, which mandates lots of reports from school districts to make them more "accountable" (I won’t get into the heated debate over this goal because it isn’t a document engineering issue).

The déjà vu part of this story is that like the computerized pupil records required by No Child Left Behind, the US government has also called for electronic patient records. Last November the Department of Health and Human Services began funding multi-million dollar pilot projects and even conservative estimators expect that it will take hundreds of billions of dollars to make EHRs happen for everyone in the US.

Maybe we could save ten or twenty billion bucks by recognizing that implementing electronic students and electronic patients have a great deal in common and are also likely to face similar non-technical challenges in their implementation and adoption.

-Bob Glushko

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