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Is paper a scapegoat? Perhaps paper is just an easy target. Eliminating paper- based processes is a simple concept for the public, politi- cians and investors to understand through brief sound bites. Politicians tout the benefi ts of EHRs and HIEs in their speeches. Investors hype companies with potentially transformative technology. Consumer media outlets portray the implementation of EHRs to be as simple as installing an application on a desktop computer or ac- cessing a Web site. These oversimplifi cations add to the public’s perception that

Damon Braly is a freelance writer specializing in healthcare information technology, and is a former editor of Health Management Technology magazine. He can be reached at

the healthcare industry is dragging its feet. After all, if millions of Americans can manage their lives from the convenience of a smartphone, why can’t the healthcare industry achieve widespread implementation of EHRs and HIEs that rid the system of paper? The trouble is that the industry-wide elimination of paper sounds simple, but it’s not easy and perhaps it’s not even practical. I’d like to think that the industry’s major

initiatives have much broader goals, such as improving patient outcomes and reducing the cost of care. And for the most part, I believe that the industry (software ven- dors included) is pursuing those broader goals. However, explaining the complexity of those initiatives does not make for good sound bites. Further complicating matters are the numerous competing perspectives on the subject, including providers, payers, vendors, investors, patients and the government. Rarely do all of these perspectives align. That creates a tremendous amount of pressure for today’s healthcare organizations. Additionally, there are often incentives – occasionally even large fi nancial incentives from the government and other entities – that pressure organizations to align themselves with the priorities of others. The oversimplifi cation of healthcare’s complex issues allows paper to be an easy scapegoat. Like healthcare’s Holy Grail, paper has become a metaphor. If the expecta- tions for healthcare’s Holy Grail are for a truly paper-free industry, I doubt that I’ll live long enough to see that day. For me, I like to envision healthcare’s Holy Grail as a paper cup. It’s a good sound bite, and the irony of that suits me just fi ne.



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