If Interoperability is the chief goal of the EMR Evolution, then Meaningful Use 2 is a big step in the right direction. The Direct Project and the Patient Portal open the door to a new world of medical information communication. Since more information in the hands of the Doctor at the point of care translates into more accurate diagnosis and treatment (on a statistical basis), Interoperability will improve outcomes and prevent a quantum of adverse events. The corollary of this is that Interoperability must be efficient in terms of ease of use and speed of transaction. Anything else will render useless our large investment in HIT Interoperability. This, of course, assumes that the Patient Data being communicated is accurate since inaccurate Patient Data will perpetuate past errors and end up doing harm. So it is vitally important that Doctors enter accurate Patient Data into the System, for in this new era of Electronic Data every data point entered is being published through the System. Now as to the frenzy being generated by the expectancy that great efficiencies/advancements will come from the computerization of Medicine, let me supply a dose of reality. Contrary to current thinking, documentation of medical data and events in the patient’s chart – whether the chart is electronic or paper – has absolutely nothing to do with the quality of medicine being practiced, except that the chart must document accurately the patient’s essential data so that the Doctor can review that data as he is seeing the patient. Documentation is only documentation and aside from the important previous statement it has no bearing on the patient’s outcome. Furthermore, the present investment in Analytics (big data) will not prove to be of any value – it will go down as an enormous waste of time and dollars. The computer generated analysis of trillions of medical data points will either mislead us or merely tell us things that present knowledge and experience have already told us.