THE BURNED OVER DISTRICT

Once upon a time. Back in primitive times, when doctors relied on paper records for medical histories, sharing patient histories was a simple matter of making a paper copy and passing it on to another doctor, with the patients written permission. This was slow and required lots of file space. Nowadays, doctors use computerized records relying on whizbang software that moves at the speed of light around the globe, but only to doctors who use the same software.

As a practicing physician in Ahoskie, N.C., the ear, nose and throat specialist Dr. Raghuvir B. Gelot says little has frustrated him more than the digital record system he installed a few years ago.

The problem: His system, made by one company, cannot share patient records with the local medical center, which uses a program made by another company.

The two companies are quick to deny responsibility, each blaming the other.

Regardless of who is at fault, doctors and hospital executives across the country say they are distressed that the pricey electronic health record systems they installed in the hopes of reducing costs and improving the coordination of patient care — a major goal of the Affordable Care Act — simply do not share information with competing systems.

The issue is especially critical now as many hospitals and physicians scramble to install the latest versions of their digital record systems to demonstrate to regulators starting Oct. 1 that they can share some patient data. Those who cannot will face reductions in Medicare reimbursements down the road.

On top of that, leading companies in the industry are preparing to bid on a Defense Department contract valued at an estimated $11 billion. A primary requirement is that the winning vendor must be able to share information, allowing the department to digitally track the medical care of 9.6 million active-duty military personnel around the globe.

The contract is the latest boon to an industry that has been heavily subsidized by taxpayers in recent years through more than $24 billion in incentive payments to help install electronic health records in hospitals and physicians’ offices.

While the vast majority of providers have installed some kind of electronic record system, two recent studies have found that fewer than half of the nation’s hospitals can transmit a patient care document, while only 14 percent of physicians can exchange patient data with outside hospitals or other providers.

“We’ve spent half a million dollars on an electronic health record system about three years ago, and I’m faxing all day long. I can’t send anything electronically over it,” said Dr. William L. Rich III, a member of a nine-person ophthalmology practice in Northern Virginia and medical director of health policy for the American Academy of Ophthalmology.

The free hand of the marketplace has struck again and private enterprise has once again failed to do it better. Until some maker "Googles" the market and achieves total dominance, there will be no standard for universal communication.