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June 6, 2012

Electronic Health Record Technology—Reply

Author Affiliations

Author Affiliations: Stanford University School of Medicine, Stanford, California (Dr Wang; cjwang1@stanford.edu); and Duke University School of Medicine, Durham, North Carolina (Dr Huang).

JAMA. 2012;307(21):2255. doi:10.1001/jama.2012.3530

In Reply: In response to Mr Nahass and Dr Nahass, we agree that interoperability is critical for allowing different EHR systems to connect. We see interoperability and security standards as ramps and traffic signs to entering and exiting the information highway, and key in establishing a universal database. The government or a credible agency will need to set standards with input from industry; the standards will need to be rigorously evaluated, as was done in the development of e-prescribing.1 Both proprietary and nonproprietary systems can compete for market share based on their user interface design or overall systems capability. Patents and copyright protections have been central to technological innovations; however, studies suggest that patents can also impede innovation if they are overdone.2,3