Traversing The Digital Divide

PREFACE: Some challenges in the health care system are new and some areold. Helen Burstin, a general internist, writes about a new problem: the emerging digital divide that she encounters as an enthusiastic explorer in the new land of computer-assisted medical practice. She describes the disparity between the “highly evolved” information environment of an academic health center and the absence of computers at a minimally funded inner-city clinic. Her experiences underscore the potential for the spectacular benefits of the computer in medicine to drive an ever larger wedge between the rich and the poor in health care. Daniel Derksen, a family physician, writes graphically and disturbingly about an old problem that we haven't bested: drinking and driving. While public outcries against drunk driving are common and DWI laws and seat belt regulations are on the books, 45,000 people a year still die on U.S. highways—two-thirds of them in alcohol-related crashes. Derksen reminds us about the horror of these deaths and how much more vigilance could be brought to bear to prevent them.