At the 2011 American College of Medical Informatics (ACMI) Winter Symposium we studied the overlap between health IT and economics and what leading healthcare delivery organizations are achieving today using IT that might offer paths for the nation to follow for using health IT in healthcare reform. We recognized that health IT by itself can improve health value, but its main contribution to health value may be that it can make possible new care delivery models to achieve much larger value. Health IT is a critically important enabler to fundamental healthcare system changes that may be a way out of our current, severe problem of rising costs and national deficit. We review the current state of healthcare costs, federal health IT stimulus programs, and experiences of several leading organizations, and offer a model for how health IT fits into our health economic future.

We outline a systematic approach to defining, eliciting, and specifying the structure and the information content of the electronic health record (EHR). The paper presents a scheme for specifying a uniform, but extensible EHR and for eliciting both the structure and contents of this EHR. The next step will be to carry out the proposed process with health-care providers to begin to put some order into health records and to allow specifications of families of interacting HI applications.