President Barack Obama has big plans to make health care more efficient, thereby making it less expensive for you and me. To hear about his plans in the media, we're led to believe his strategy is based in large part on getting health care providers and insurers to do more activities using an efficient integrated electronic system. Other industries have been doing it effectively for years.

Manufacturers, such as the big three automobile companies, work with their dealer networks this way. Massive retailer Wal-Mart shares sales data with consumer products companies to help them forecast demand. Dell uses just-in-time techniques to alert suppliers to the exact orders being taken so the suppliers can replenish Dell's computer parts just on time to put them in computers. Everybody wins in these connected scenarios.

Then, there's the medical industry. It uses a lot of automation already; but there are way too many islands of information, not all practitioners use the information effectively and if my experiences with their customer-facing interfaces are any indication, they still haven't mastered the art of an easy user experience. That will make it very challenging for the president to accomplish his goal.

Highmark Blue Cross Blue Shield's Web site is a good example of how difficult it is to implement. When working, it offers great information, such as what you've spent on health care and what you still owe to your doctors. But it's often unavailable, and it's difficult to navigate.

On a recent Sunday afternoon, my wife and I tried in vain to use the Highmark Web site to access our medical data, only to hit roadblocks. On that date, it alternated over several hours between total unavailability (demonstrated by not being able to load any page) and showing a message that the Web site was unavailable. Unfortunately, similar problems have happened to us several times, leading my wife to sigh about how difficult it is to manage our health care expenses.

With access problems like that, it's no wonder people like my wife are nervous and concerned about putting data online. There's no telling whether they will be able to get to their information. Imagine not being able to reach your payment account to pay your bills and having it affect your payment record.

At Highmark, once you've been able to log in and figure out the system, you can reach your own account information, such as which doctors have provided services, which have been paid by insurance and how much you owe. If set up in advance, you can even pay your bills using a health savings or similar account.

It's a good start, but it needs improvement, not only locally, but also the way the whole system works across the nation. We need full participation by doctors, anesthesiologists, dentists, hospitals and other health providers -- comprehensive billing through one source -- in a single, consistent format.

We need easy bill presentment, medical tracking and payment throughout the whole system -- from small medical practice to large groups and hospitals. And it needs to transcend billing and insurance. It needs to encompass the actual medical records, images and histories that doctors can pull up when needed -- even when the information comes from another practice.

The government is prepared to throw a lot of money at the problem. But simply throwing money at creating a system does not guarantee success. If Mr. Obama and his team are to be successful, they'll need to set very specific criteria to define success -- including requiring the creators to work with medical practitioners and ordinary citizens to see how well they adapt to the new systems and how well the systems adapt to them.