I would think future EHRs will implement some form of patient driven privacy. Privacy is different from security. Security is about passwords, authentication, encryption, etc, Privacy is about granting access to specific patient information. Who is in charge of that? The patient? At least the patient should be informed any and every time their health information is accessed by any person for any reason. Exactly what part of the health record that was examined should be forwarded to the patient.

EHRs with a mobile app allowing some functionality should be the norm. There are some really great apps for specific vendor products, and the one I am speaking of specifically is amazingly easy to use. Over time, a physician will best improve his practice management by having more and easier access to the data.

The base layer of the committees that formed the "meaningful use" was privacy. It establishes a standard but flexible way that record access can be restricted to the patient and medical professionals involved with treatment. The five features given are essential, but without the privacy both the medical staff and the patients will boycott their information storage, no matter the medical benefit.

If every divorce, employment application, and traffic ticket results in a breach, then all the benefits that ARRA promises will be lost.

EHRs are great for sharing documentation and detecting drug-drug interactions, but we're definitely underutilizing their computational potential. The next generation would need to have enough flexibility to incorporate advances in the medical evidence (e.g., detect new adverse events related to existing meds, suggest meds based on clinical profile) and would leverage processing speed to allow true CDS - clinical diagnostic support, ala DXplain and Isabel. It's bad enough that wrong-site surgery still exists; we shouldn't continue to miss the occasional zebra.

While data portability and interoperability will be highly important, the use of the term "liquidity" is odd--to the extent that liquidity typically refers to the speed with which an asset can be converted to cash.