Why Are We Still Using CDs, Paper, and Outdated Methods for Medical Data?

One evening, a cancer patient undergoing chemotherapy in a major tertiary hospital in the Seoul metropolitan area developed a high fever while staying in his hometown and was rushed to the local emergency room. The ER staff knew he was a cancer patient but had no access to his medical records. An X-ray suggested chemotherapy-induced pneumonia, but without previous imaging, they couldn't determine how much it had worsened. Additionally, they had no way of confirming what medications he had been prescribed before.

Without access to prior medical records, the ER doctor struggled to determine the best course of treatment. While additional tests were necessary, the lack of previous imaging made it difficult to assess whether the patient's condition had worsened. Moreover, without records of past prescriptions, the doctor faced challenges in deciding the safest and most effective treatment plan.

What if medical data had been seamlessly shared? The patient could have received the appropriate treatment without unnecessary delays, as doctors would have had access to his medical history and previous test results. (Of course, assuming interoperability guarantees optimal care is an oversimplification—this will be discussed in a future post.)

Yet, in 2025, hospitals are still relying on CDs, paper, outdated methods, and inefficient communication tools. Why is this still happening?

The illustration of a doctor looking frustrated while holding a stack of paper medical records and a CD, overwhelmed by outdated methods in a hospital setting.

 

The Real Cost of Data Silos in Healthcare

Medical data silos have real consequences for both patients and healthcare providers. When hospitals lack access to previous records, patients often face unnecessary tests and procedures. For instance, a patient who had laboratory or imaging tests at a tertiary hospital may need to have the same tests repeated at another facility because their medical history is difficult to access. In Korea, some medical records is shared through the Health Information Exchange (HIE) service operated by the Korea Health Information Service, a public institution, and the Health Insurance Review and Assessment Service (HIRA) portal. However, HIE has limited participation from medical institutions, with only 61 major hub hospitals and 8,605 participating medical institutions as of December 31, 2023, and the HIRA portal was originally designed for insurance claims, making its functionality insufficient for comprehensive medical data sharing. This lack of shared data can delay diagnosis and treatment, increase healthcare costs, and place an unnecessary burden on both patients and healthcare providers. In some cases, it may also lead to poorer patient outcomes, as delayed or suboptimal treatment decisions can negatively impact recovery and overall prognosis.

To utilize HIE, each medical institution must upgrade its IT systems. However, primary and secondary healthcare providers typically lack dedicated in-house IT teams and rely on outsourced services. These vendors are often reluctant to support HIE unless financial incentives are provided. Additionally, even when using HIE, the interface is cumbersome, making it difficult for providers to fully integrate the system. A more detailed discussion on these challenges will be covered in a future post.

The delays caused by missing medical history can be even more critical in emergency situations. ER doctors rely on accurate, up-to-date patient records to make informed decisions quickly. Without access to a patient’s prior imaging, medication history, or past diagnoses, doctors are left to rely on guesswork, which can lead to treatment delays or even incorrect medical decisions. In time-sensitive cases, such as stroke or sepsis, even a few minutes can make a difference in patient outcomes.

Beyond direct patient impact, inefficiencies in medical workflows result in lost time and increased workload for healthcare professionals. Doctors and hospital staff often spend hours manually requesting and verifying patient records through outdated methods, such as fax machines or couriered documents. This administrative burden not only takes time away from patient care but also contributes to burnout among healthcare workers. Addressing these inefficiencies is not just about improving convenience—it is a necessary step in building a more effective and sustainable healthcare system.

 

How Do Other Countries Handle Healthcare Interoperability?

Several countries have made significant progress in healthcare interoperability. In the United States, the 21st Century Cures Act introduced Fast Healthcare Interoperability Resources (FHIR) as a standardized framework for data exchange. This initiative has improved the ability of hospitals and healthcare providers to share medical records seamlessly, reducing the burden on patients to manage their own records.

Similarly, European nations have taken steps toward cross-border healthcare data sharing. The eHealth Digital Service Infrastructure facilitates secure medical data exchange across EU countries, ensuring that patient records can be accessed by authorized providers regardless of national boundaries. This has been particularly beneficial for individuals receiving medical care while traveling or living abroad.

In contrast, Korea is still in the early stages of establishing a unified, national standard for healthcare interoperability. While some hospitals have begun sharing data through localized networks, a fully integrated system connecting all medical institutions has yet to be established. As a result, many patients must physically carry their medical records between facilities, leading to delays and gaps in care. Addressing these shortcomings will require coordinated efforts between policymakers, healthcare providers, and technology developers.

 

 

The Path to True Healthcare Interoperability

Achieving full healthcare interoperability requires a multi-faceted approach. One key step is the standardization of Electronic Medical Records (EMR) systems. Hospitals must adopt compatible and standardized digital platforms to facilitate seamless data exchange. Without common standards, even digital systems can function as isolated silos, limiting their effectiveness. The government has also recognized this issue and, in early 2025, launched a national initiative to enhance interoperability. (Source) Additionally, a patient-centered medical imaging sharing pilot project has been underway since the latter half of 2024. (Source)

A national data-sharing platform would further enhance medical record accessibility. An integrated cloud-based infrastructure could enable real-time access to patient histories, imaging results, and medication records, facilitating seamless data exchange while maintaining security and efficiency. By integrating existing hospital systems into an interoperable network, healthcare providers would no longer need to rely on outdated communication methods to request and transfer patient data.

Empowering patients with control over their medical data is another crucial component. Patients should have the ability to access their own records and grant permissions to healthcare providers when needed. By utilizing digital health technologies, such as mobile apps or patient portals, individuals can take a more active role in managing their health information. Currently, the Korean government is implementing a PHR (Personal Health Record) initiative called 'My Healthway,' which warrants attention as part of this shift towards patient-centered data management.

Furthermore, Korea’s Tertiary Hospital Structural Reform Pilot Program presents an opportunity to incorporate interoperability into a larger healthcare transformation. As Korea transitions toward a structured referral system, ensuring seamless data exchange between tertiary hospitals and smaller regional facilities will be critical for optimizing patient care and reducing administrative burdens.

 

What Happens When Medical Data Flows Freely?

When healthcare interoperability becomes a reality, the benefits will be far-reaching. Patients will no longer need to undergo redundant tests or carry physical copies of their medical records between hospitals. Instead, doctors will have immediate access to comprehensive patient histories, allowing for faster and more informed decision-making.

In emergencies, real-time access to critical information—such as medication allergies or pre-existing conditions—could save lives. When doctors are equipped with complete and accurate patient data, they can administer the most appropriate treatment without delay.

Moreover, interoperability has the potential to reduce overall healthcare costs. By eliminating unnecessary procedures and administrative inefficiencies, hospitals can allocate resources more effectively. Healthcare providers can focus on delivering high-quality care rather than navigating bureaucratic hurdles. (I acknowledge that this is merely a theoretical advantage of interoperability and that criticisms exist. I will address these concerns in a future post.)

By addressing these challenges, we can move toward a healthcare system that prioritizes patient care over administrative barriers. True healthcare interoperability is not merely a technological upgrade—it is a necessity for creating a safer, more efficient, and patient-centered medical system.