Advanced technologies that rely on this computing power have become widespread. In the United States, 85 percent of adults own a cellphone, almost half own a digital music player, and 76 percent own a laptop or desktop computer (Zickuhr, 2011). The ability to generate, communicate, share, and access information has also been revolutionized by the rapid growth of digital networks. The Internet pervades modern life, allowing for quick access to multiple sources of information and rapid communication. The number of Americans with access to the Internet grew from 14 percent in 1995 to almost 80 percent in 2011 (Pew Internet & American Life Project, 2011). The Internet has given rise to new ways to connect with others, such as through social networking sites. These sites are now pervasive, being used by 65 percent of Internet users as of 2011 (Purcell, 2011).

In recent years, connectivity has become mobile and ubiquitous. Since the turn of the century, the capacity to share information across telecommunications networks has grown by an average of 30 percent per year (Hilbert and López, 2011). With the rise of tablets and smartphones that offer Internet connectivity and additional applications, mobile devices have become more sophisticated and have gained greater functionality. It is estimated that by 2020, 10 billion such mobile Internet-connected devices will be in use (Huberty et al., 2011).

These advances have dramatically changed numerous sectors of the U.S. economy, and even society more broadly. Companies have developed new ways to streamline their work processes, share information within their organizations, and analyze trends and knowledge (see Box 4-1 for an example). Individuals now have a wealth of information at their fingertips, with the ability to learn about almost any new topic in seconds.

While technologies and communications have led to widespread societal changes, these capacities are still relatively early in their development in the health care arena, and there is substantial room for progress and improvements as technologies are implemented in the field. One way digital connectivity can lead to better performance in health care is by ensuring that clinical information for a given patient is available when and where it is needed. The infrastructure for this type of connectivity, however, is largely lacking. As of 2011, only 34 percent of office-based physicians used a basic electronic health record system (although projections are for 90 percent to have access by 2019) (Congressional Budget Office, 2009; Hsiao et al., 2011), and only 18 percent of hospitals had a basic system (DesRoches et al., 2012). Thus, substantial opportunities exist to improve the safety and efficiency of medical care by promoting greater use of digital records. Once in place, these systems create the potential for advanced uses of clinical data to improve outcomes (see Box 4-2 for an example). For instance, they allow providers to analyze their patient populations and identify those who may benefit from preventive care or other proactive clinical services.



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