BLOOMINGTON, Ind.

AMERICA NEEDS a national health-information network that respects patient confidentiality but that also lets hospitals share records across states quickly, seamlessly and accurately.

When my son — a general surgeon — became severely ill with bacterial meningitis and went into a coma, he was treated in various facilities. Although the clinicians were wonderful people who cared intensely for our son, too often they were forced to treat him with incomplete information. Each time, he was moved from one facility to another, his medical records became unavailable for a time. Diagnoses were made sometimes without the benefit of the latest imagery.

As a business professor, former bank CFO, retired Marine reserve general, and consultant, I am no stranger to organizations. I immediately recognized the symptoms of poor information systems and a lack of sound organizational processes. No substantial organization I’d been associated with would operate like that. I could readily see where this setting was ripe for disaster.

I decided to investigate why health-care informatics is so primitive.

Teaming up with Professors Arlen Langvardt and Anne Massey, at the Indiana University’s Kelley School of Business, we focused on legal barriers to a National Health-Information Network. In an article in the Journal of Law, Technology and Policy, we argue for a national legal framework to create such a network. We found that current legal barriers to such a network’s formation include a patchwork of state and federal patient-privacy laws, flaws in federal physician anti-kickback and anti-self-referral statutes, prohibitions against practicing medicine across state lines, and concerns about medical malpractice in an electronic health-care environment.

Quality issues abound in health care. The Institute of Medicine has stated that as many as 90,000 people are killed annually through medical errors. Research suggests that electronic health care can substantially reduce that figure. Yet health care in the U.S. has been likened to a 747 flown with biplane controls when it comes to how far behind it is with informatics. Instead of a national health- information network, what exists has been described as a business accounting for 16 percent of U.S. gross domestic product that runs on scribbles on paper and, according to the comptroller general, threatens to bankrupt the country.

Although some progress has been made in addressing these issues, the current state of federal and state regulation falls woefully short of that necessary for creation of a National Health Information network. The approach taken so far is more reminiscent of the largely bottom-up evolution of cellular service in the U.S. than what one would think would be a top-down priority with so many lives at stake.

Politicians rave about the need for affordable health care, but too little is done in the area of eHealth. Instead of taking the initiative and forcing the issue top down, they are implicitly hoping for a bottom-up solution while taking partisan stances in the periodic debates over medical-malpractice liability.

Health care is a national problem; but, at least from a legal standpoint, Washington is largely treating it as a state problem. The nation can ill afford a wait-and-hope strategy that depends upon a true National Health-Information Network evolving bottom up through harmonization of myriad state and federal laws.

This is one area where the federal government could act and needs to act, but will Congress and the next administration have the vision and political courage to make a bold move that could save countless live and reduce health-care costs? The nation needs revolution, not evolution, in health-care informatics.

John W. Hill is a professor of accounting at the Kelley School of Business, Indiana University ( hillj@indiana.edu).