Medical Professionalism in the New Information Age

Medical Professionalism in the New Information Age

Medical Professionalism in the New Information Age

Medical Professionalism in the New Information Age


With computerized health information receiving unprecedented government support, a group of health policy scholars analyze the intricate legal, social, and professional implications of the new technology. These essays explore how Health Information Technology (HIT) may alter relationships between physicians and patients, physicians and other providers, and physicians and their home institutions. Patient use of web-based information may undermine the traditional information monopoly that physicians have long enjoyed. New IT systems may increase physicians' legal liability and heighten expectations about transparency. Case studies on kidney transplants and maternity practices reveal the unanticipated effects, positive and negative, of patient uses of the new technology. An independent HIT profession may emerge, bringing another organized interest into the medical arena. Taken together, these investigations cast new light on the challenges and opportunities presented by HIT.


David J. Rothman and David Blumenthal

As we write this introduction, President Barack Obama has signed the American Recovery and Reinvestment Act of 2009 into law. This nearly $800 billion effort to shore up the foundering U.S. economy will have diverse and unpredictable effects, but one certain consequence is the wiring of our health care system. Between $14 and $27 billion of the $800 billion will go toward supporting— financially, logistically, technically—the acquisition and use of electronic health records (EHRs) by the nation’s health care providers, including physicians and hospitals. An investment in EHRs on this scale was inconceivable before November 4, 2008, and before the collapse of the U.S. economy. Now there seems to be no turning back.

President Obama, his aides, and legislators of both political parties are hoping that the spread of EHRs will yield huge dividends in terms of the quality and efficiency of our health care system. That is a wish that all Americans likely share. But at the same time, a social investment of this size and novelty inevitably raises questions about unanticipated consequences, both positive and negative. in this volume, we explore one such possible effect: the implications of health information technology (HIT)—of which EHRs are just one example—for the profession of medicine, and in particular, for the professionalism of physicians.

At first glance, this may seem an odd direction in which to take discussions of hit. Most of the literature in the field tilts toward economic, clinical and technical analysis: how to design the best electronic records; how to protect patient privacy and data security; and how to ensure that EHRs positively affect quality and reduce costs. We are asking a different but equally important set of . . .

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