EHR's Are What Are Made of Them

Implications: The porridge of attention being lavished upon anything related to augmentation of quality and outcomes in medical practice is becoming counterproductive and is obscuring important "currents" of information. To summarize EHR's as offering no benefit is akin to saying that the iphone given to John F Kennedy's secret service detail failed to provide any advanced notice of the shooting, nor did it make less the chaos that followed. An iphone without a cell network, and without other people with phones, is a brick. Similarly, EHR's without a rich and robust informatics network and without other places using EHR's is just really an expensive "brick".

Analysis: 1. Tools are specific to a time and a place. A hammer without a nail, in a world where wood is not used for building, it not very useful is it.

2. EHR's are not a panacea, but rather a tool that require the timing and a venue to show value.

3. Those, with a few notable exceptions like the VA, who are currently seeking to capitalize upon the promise of this "tool" are doing so without a full appreciation of both these requirements. An iphone without a cell network, and without other people with phones, is a brick. Similarly, EHR's without a rich and robust informatics network and without other places using EHR's is just really an expensive "brick".

It is neither slower than expected, nor a sign of impending doom. They require more dedicated attention and cognitive focus that short term annual reporting of progress will allow. Patience is key.