Moves Too Fast, Risk Systemic Blowback
IEEE Spectrum - AI
Jul 31, 2025 16:00
Harry Goldstein
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Summary
The rapid, interoperability-agnostic rollout of electronic health records (EHRs) in the U.S. led to costly, insecure, and inefficient systems that increased clinician burnout and medical errors. This case highlights the dangers of prioritizing speed over thoughtful design and integration—an important caution for the AI field, where similar pressures could result in systemic risks and unintended consequences if interoperability and long-term impacts are ignored.
One of the most sobering insights from Contributing Editor Robert N. Charette’s feature story in this issue is that the 20-year rollout of electronic health records (EHRs) in the United States happened with an intentional disregard for interoperability. As a result, thousands of health care providers are “burdened with costly, poorly designed, and insecure EHR systems that have exacerbated clinician burnout, led to hundreds of millions of records lost in data breaches, and created new sources of medical errors,” Charette writes. The U.S. government made this myopic decision in order to speed up EHR adoption, ignoring the longer-term costs. The operating mantra, says Charette, was that EHR systems “needed to become operational before they could become interoperable.” You could call what happened next “unintended consequences,” but that would absolve decision-makers in government and industry for making choices they knew could compromise user experience, security, and patient outcomes. T