This was taken from a colleague’s post on a medical informatics listserve. I’m reproducing it with only minor edits here because it deserves a much wider audience. Wish I had thought of it but cannot take the credit.
Step 1) Government fails to recognize EHRs, their data, and workflow as a
public good versus a private good. Think lighthouse or highways versus a
house or car.
Step 2) The government, at private industry’s behest, decides to spend public
money indiscriminately with no provision or attempt to create public goods in
Step 3) Public money is mostly used to create more private property
(proprietary EHR software, data and workflow).
Step 4) The public money is now largely spent. Private toll booths
everywhere. Large amounts of legally protected private property exist that surprise! do not meet interoperability objectives.
Step 5) The light bulb goes on. Our leaders are shocked, shocked to find
that interoperability is not occurring despite billions spent.
Step 6) Our leaders now want to unravel or bolt something on to the legally
protected private property created with public money. The private property is
inherently not interoperable and is in fact hostile to interoperability.