Philadelphia has a proud history of leadership in health care. Philadelphia is home to the nation's first hospital, first medical school, and first medical society.

Over the last 250 years, those seeds have grown into a $2-trillion-a-year system, with more than 800,000 doctors and 6,000 hospitals. But far too often, today's doctors and hospitals are using tools and technology that, relatively speaking, are from a distant age.

From ATMs and instant messaging to Travelocity and eBay, technology is second nature to us. But when Americans step inside the health-care system, we step back to a time of paper-based medical records and color-coded filing systems. That is why getting health information technology into the hands of health-care providers must be one of our nation's top priorities, and we must act now.

The technological gulf in health care isn't just inefficient and costly; it may also be involved in costly inefficiency and the persistence of a high error rate in medicine. Last year the Institute of Medicine issued a startling report, stating that 1.5 million Americans are injured or killed every year because of medication errors, costing at least $3.5 billion. This follows the institute's landmark 1999 report that concluded that up to 98,000 Americans are killed every year by other types of preventable medical errors. As for costs, some experts believe that as much as 40 percent of health-care spending - $800 billion a year - is waste.

Health information technology, from electronic prescribing to electronic health records to clinical decision support, is a critical part of the solution. And medical practitioners in Pennsylvania are leading the way.

These include the caregivers at Chester County Hospital in West Chester, who implemented a workflow solution to identify every patient with a known superbug infection so he or she was managed and isolated properly, protecting staff and other patients from possible exposure. Richard Baron heads Greenhouse Internists, a four-doctor practice in Philadelphia, which implemented electronic health records and saved $65,000 a year in transcription and staffing expenses. Seventy-eight of Baron's patients were taking Ortho-Evra, a contraceptive patch, when new dangers were announced by the Food and Drug Administration, and they were notified the very same day. Greenhouse's electronic health record identified them in seconds.

Unfortunately, these are the exceptions. Only a quarter of all hospitals and less than 15 percent of all physicians use information technology in the delivery of care. So how do we change this?

Consider incentive options for physicians and other health-care providers to encourage them to adopt information technology. Payment models should not be changed for the sake of technology itself, but for the better-quality care it would help deliver. Baron and colleagues invested nearly $140,000 in their electronic health-records system, streamlining the care of their patients, but they received zero additional payments from any insurer - not Independence Blue Cross, not Medicaid, not Medicare. In other words, Baron and colleagues are paid the exact same rate as a practice that uses a paper-based system.

Break down legal barriers to the adoption of technology. Think of the federal Stark Law and anti-kickback statutes, which until last fall imposed an outright ban on virtually any information technology collaboration between doctors and hospitals (such as giving a doctor electronic access to the hospital's IT system). The federal government relaxed the restrictions a bit, but made the hoops so onerous that few hospitals would go through the trouble to wire their communities. From Medicaid regulations to antiquated statutes from decades ago, all of them should be broken down to expedite the adoption of IT.

Ingrain the use of health information technology into the curriculum of our nation's medical schools. Jefferson Medical School requires that interns and residents use a computerized physician-order-entry system to help with medication prescribing, and they use personal digital assistants to track their patients' status electronically and to assist with information transfer during shift changes. Other medical schools have begun to split their curricula between clinical and IT education. This is a long-term strategy that can teach a new generation of doctors and other providers who will demand these tools.

Physicians and other health-care providers are eager to use health information technology. According to a physician survey by Manhattan Research, 99 percent of doctors surf the Web, 95 percent use search engines to find medical information, and 90 percent have a high-speed Internet connection. The sad reality is that most physicians put down their laptops and pick up their clipboards when they walk into a patient's room. For the health of our citizens and the future of our country, that's a reality we must change. In the words of Ben Franklin, "You may delay, but time will not, and lost time is never found again."