Electron-impact ionization of the hydrogen atom is the prototypical three-body Coulomb breakup problem in quantum mechanics. The combination of subtle correlation effects and the difficult boundary conditions required to describe two electrons in the continuum have made this one of the outstanding challenges of atomic physics. A complete solution of this problem in the form of a "reduction to computation" of all aspects of the physics is given by the application of exterior complex scaling, a modern variant of the mathematical tool of analytic continuation of the electronic coordinates into the complex plane that was used historically to establish the formal analytic properties of the scattering matrix. This review first discusses the essential difficulties of the three-body Coulomb breakup problem in quantum mechanics. It then describes the formal basis of exterior complex scaling of electronic coordinates as well as the details of its numerical implementation using a variety of methods including finite difference, finite elements, discrete variable representations, and B-splines. Given these numerical implementations of exterior complex scaling, the scattering wave function can be generated with arbitrary accuracy on any finite volume in the space of electronic coordinates, but there remains the fundamental problem of extracting the breakup amplitudes from it. Methods are described for evaluating these amplitudes. The question of the volume-dependent overall phase that appears in the formal theory of ionization is resolved. A summary is presented of accurate results that have been obtained for the case of electron-impact ionization of hydrogen as well as a discussion of applications to the double photoionization of helium.