Students predict the future of health records
It's hard to predict just how the effort to move medical records from paper to digital will shape up.
That said, a collection of business students recently gave it their best shot. As part of an annual "war game" exercise, students from such schools as Penn's Wharton School of Business took on the roles of key industry players in an effort to imagine how the battle to digitize America's health records will play out.
Among their predictions: entrenched interests will slow change, industry players will have to consolidate, and the financial pressure will need to be increased to get the industry to fully move to digital records.
"Adoption will come at a much slower speed than I think people would like," said Leonard Fuld, the consultant who organizes the yearly war games event. "Entrenched interests will resist electronic medical records for a much longer time."
Even if the intransigence abates, the industry will be able to move only so fast, Fuld said.
"If truly they gain momentum to move ahead, there's actually going to be a manpower shortage to make all that happen," Fuld said, echoing an issue raised in the first part of CNET News' three-day special report on the digital records push.
One of the other predictions is that the massive flow of dollars into this space will spur merger activity.
"It's almost a foregone conclusion there is going to be some mergers within the marketplace," Fuld said, saying that the students believed that the health care-specific tech companies such as Allscripts and Cerner might be attractive to larger firms wanting a piece of the action.
"They can't do this alone," Fuld said.
The war game exercise featured students from four schools: Penn's Wharton School of Business, the Columbia University School of Business, MIT's Sloan School of Management, and Northwestern's Kellogg School of Management
Fuld said students' past predictions on other topics have often proved prescient.
Below is a short video Fuld's organization produced with excerpts from the April event.
During her years at CNET News, Ina Fried has changed beats several times, changed genders once, and covered both of the Pirates of Silicon Valley. These days, most of her attention is focused on Microsoft. E-mail Ina. 
1. Lack of standardization. I see a time when these records are no longer just for internal use, and there will be problems with data format, secure transmission, etc.
2. What happens when the technology fails? We have plans in-place for downtime, but they are cumbersome. Printing Medical Administration Records for the whole hospital AFTER the failure isn't the same as printing them before they need them.
And so far, one problem I've seen is the poor quality of the solutions out there. A drug administration system that defaults to certain times instead of what is prescribed, fields with limited precision that "round up" to the next whole number, drug supply machines that freeze-up so staff cannot access the drugs, requiring Pharmacy to send them after much delay and paperwork, new Order systems that do not provide an order #, which all the other systems use, so you cannot track where a lost order went to, interface monitors that "freeze", leaving you to believe that everything is ok when actually there may be an interface down (you have to monitor the "interface monitor"!)
Need much more ground work - this is a space-like program not a debugging process as Microsoft does.