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How Your Health Records Became a Health Crisis

At the simplest level, digitization means changing something, particularly information, into digital form. But that elemental description well underplays the size, the force, the impact of this process. Across the landscape of business, digitization has been nothing short of a seismic wave, shaking the foundations of venerable industries that had stood imperturbable for decades. It has uprooted business models, seeded instant commercial giants and demolished others, erased some jobs and transformed others overnight.

For consumers, however, the digital wave has brought mostly good things, it seems: more convenience, more flexibility, more options. Indeed, it’s hard to think of any technological change that has delivered more power to consumers than this—thanks in large part to the digital devices we carry in our pockets or handbags. Sure, we may all be addicted to our smartphones now, but who can argue with the prospect of ordering dinner, or a car ride, or a plane ticket at the speed of a few clicks?

It was such thinking that drove the federal government a decade ago, at the dawning of the age of the iPhone, to push for a digital transformation of health care. Again, who could argue with the prospect of turning the unreadable scrawl of a physician’s hand into an electronic record? Who could be against the notion of migrating miles and miles of paper medical charts to an interactive database that could be accessible anywhere, anytime?

In theory, the nationwide push to electronic health records, or EHRs, would not only reduce errors (seemingly rampant in the paper-chart era) but also fuel medical discovery, as the “big data” within was scoured for new disease patterns and even clues to potential cures. That’s what thought leaders across the health care field thought. That’s what politicians across the political spectrum contended.

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Photograph by The Voorhes

And that’s what makes the investigation by Fortune’s Erika Fry and Fred Schulte of Kaiser Health News in our April issue so surprising—and so compelling. Despite a $36 billion federal investment (or maybe, as some argue, because of it), our massive effort to digitize America’s medical records has been an equally massive disappointment. Instead of an efficient, interconnected, widely accessible, consumer-friendly system, we have a barely functioning patchwork of networks that often don’t talk with one another—and that sometimes even jeopardize patient health, as Erika and Fred show.

The reporting behind their three-month investigation is simply extraordinary—and that’s why we’ve devoted 16 pages of this issue to the story. You’ll also find much more of this important saga—­including ­videos, stories from patients, and more—online at both ­Fortune.com and KHN.org.

We’ll dive in even deeper to this and other issues of digital transformation at our fourth annual Fortune Brainstorm Health conference on April 2–3. Please check out the incredible lineup of speakers and topics here. (And connect with all of our events, future and past, here.)

As those who get an opportunity to participate in our conferences understand—and longtime readers of the magazine and our many daily newsletters know as well—Fortune spends a lot of time focused on the sweeping force of digitization. We write on aspects good and bad, challenging and invigorating. We report on the disruptive, the addictive, and the informative.

But amidst all of this coverage, I have to say that Erika and Fred’s epic tale of unintended consequences has truly opened my eyes. I hope it will do the same for you.

As always, please email us at letters@fortune.com and let us know what you think.

A version of this article appears in the April 2019 issue of Fortune with the headline “Broken Records.”