Electronic medical records-a rant

I went to China on business trip two Summers ago, and while there put my bank card into a teller machine and got $200 worth of Chinese currency. A few minutes later my wife texted me and asked if I had done so. I replied yes, and she noted that she was just checking because she saw the transaction posted to our bank account (she gets a text anytime there is a cash withdraw, etc.). A very efficient transaction, with many moving parts across different continents, that occurred seamlessly (you even get the wholesale exchange rate doing it via teller).

There is no way people care more about medical privacy than they do their money. There is no way it is more complex to translate ICD-9 codes than currencies (on the fly!) and to post it within minutes. The never ending drive toward electronic medical records seems like running in the deep sand on the beach as compared to the story above. Why? It cannot be technical reasons?

There is likely an infrastructure story (how banks talk to one another), perhaps a regulation story (requiring banks to keep up with transactions, especially of certain sizes), but there must also be a part of the story driven by the fact that banks want to be able to converse with one another and that they derive some benefit(s) from this.

Who is it that doesn’t want Electronic medical records? Is there a missing infrastructure piece that must be routinized to make it happen? I really don’t get it, and can see no technical reason for electronic medical records to not be as seamless as getting Chinese currency with my bank card. Am I missing something?

update: here is a RWJF funded report on HIT adoption that was being tweeted around this morning. I haven’t read it.