I strongly suspect that for the US healthcare system setting you are talking about, the incentives are misaligned for building a better EMR/EHR system. What we

I strongly suspect that for the US healthcare system setting you are talking about, the incentives are misaligned for building a better EMR/EHR system. What we endure today satisfies those who profit mightily from it just fine, and improvements in health outcomes represent profit erosion, hence no true incentives to truly improve. Could there be more room for improvements building from the ground up in alternative healthcare environments, like co-ops, hospitals where billing is in cash only and fees for standard procedures posted up-front, concierge, etc.? I don't think the mainstream US healthcare industry will change for the better unless it is presented with an immediate (<6 months), concrete, existential threat to its existence as we know it today. Considering how unfathomably unlikely that is, then substantive improvements in health outcomes could lay only "off the grid" of the current system. Going down that path is absolutely more risky and less remunerative. Your post gives me the impression that while compensation ranks for you, I'm-On-A-Boat FU money at the expense of poor health outcomes for those you serve might not rank, so I thought I might throw out some outlier ideas and see what discussion falls out of that, if any. To give an idea of how misaligned the US system is, this blog post [1] from my reading list today came up --- but to pick one at random out of a 3-second Google would be pretty easy --- describes how in the US a $5K MRI tab is not unusual. You can fly to NRT, pay in cash in Japan for an MRI and consult, fly back, about four times for that much. Cray cray. [1] https://market-ticker.org/akcs-www?post=231917 https://market-ticker.org/akcs-www?post=231917