UK National Health Service (NHS): web-enabled primary care is finally coming, but is still super-clunky. And forget technology use in secondary care, it's non-existent. If only there was a central registry of patient's records. That would be really useful both for patients and statistical medical research. It would also be very cost effective.
The NHS is spending ?£6 billion on modernizing its information technology. Unfortunately, despite being only about one year into the project, they are already ?£1 billion pounds over budget.
I know from first hand ontology building experience that the Systematized Nomenclature of Medical Clinical Terms (SNOMED-CT), which is supposed to underly this whole revamp, is an extremely poorly architected ontology. A disaster just waiting to happen.
USA Health IT: IT in health could prevent some of the 90,000 avoidable annual deaths due to medical errors. Test often have to be re-done, because it's cheaper to re-test someone than to find the previous lab results. We need to get rid of the medical clipboard!
Knowledge diffusion is super-slow. It takes 17 years (!) for observed medical evidence to be integrated into actual practice. Empower the consumer (while also providing privacy and data protection). Also, empower homeland security to protect us from the evildoers.
Most practices don't have Electronic Health Records (EHR). Those would enable some degree of data exchange between practices, which would benefit a practice's competitors. The patient would be less tided to one doctor. Less tie-in means less profit. So, in the fierce competitive market of for-profit health care, there is little reason to go electronic.
However, SNOMED will help (... or so they say).