Speaking to the New Hampshire voters Hillary Clinton supported electronic medical records (EHR in Canada) as a way to cut cost and improve the quality of health care. Does it mean that the electronic medical record concept is reaching a tipping point after years of discussions, and we will finally see significant progress? It is unlikely. It is not the first time politicians promoted EHR; George Bush and Bill Clinton mentioned it too, but it did not go far beyond political statements.

There are two major problems. First is the cost of transition; it will not be cheap but the benefits are compelling and, ideally, in the long run it should save a lot of money. What’s more important there is no practical federal-scale model for the electronic health record. All proposed solutions are overly complex and not flexible enough; they do not provide a clear answer how the elements of the EHR infrastructure will be combined into a nation-wide, functional system that provides the expected benefits. In fact there is a risk that the promised benefits and cost savings will never materialize if EHR initiatives will keep pushing old fashioned concepts, ignoring the scale and complexity of the health care industry and the fact that health care industry is anything but a static landscape.

The Electronic Health Record is mandatory for 21st century health care, but its problems cannot be solved just by throwing billions of taxpayers’ money into it. We have to acknowledge that this is a new problem and it requires an innovative solution. Brute force is not enough.