Well, thank you. I don't want to be facetious, but I think human nature is probably at the root of it, and the causes would be subdivided into political, bureaucratic, and economic.
There's no question that getting people to sign on to electronic medical records has been somewhat difficult, but the systems they've been asked to sign on to are really very difficult and unattractive to operate. Even at this late stage, in my own tiny practice, it is impossible to go to one screen and be able to navigate through the records of one patient and be able to access narrative reports, laboratory reports, and diagnostic reports. This requires multiple exits of and re-entries to different programs and applications, and that's in a centre that's supposed to be advanced.
I think we have a lot of work to do. It's highly technical. Some of it is system-related, and some of it is related to the fact that our medical system operates as a bunch of entrepreneurial individuals hooked together by a common commitment to patient care but not by a system that supports them.