Forcing a large application into small independent parts that have to communicate with each other using minimal interfaces is always a good thing. The Mac GUI with multiple windows running applications with minimal interfaces is a good thing and in a way, a model for the future of healthcare IT - a model that will be based on a social network of doctors and their patients interacting directly through standard, lightweight, easy to use and vendor-neutral interfaces.

The US under the Obama Administration stimulus programs is awarding $42,000 to doctors that implement an EHR system. Americans in general and American medicine in particular is very hi-tech oriented indeed.

Current electronic health care systems are leading us on a path to disaster, which is increasingly clear to physicians and nurses working with these systems. So what is really wrong with current EHR systems?

Why do I say "elephant in the room"? Because when a doctor examines and treats a patient, he thinks in terms of "clinical issues" (such as those classified in the WHO ICD-10 codes), and the result of that thinking manifests itself in planning, tests, therapies, and follow-up.

How do you minimize your security and compliance risk for using the software?

The biggest resource in healthcare is the patients themselves. Why not leverage this resource in order to make physicians more effective and improve education, compliance and outcomes? We can use private social networks to connect patients directly with their physicians and healthcare providers.

How do we build a business case for a medical practice for using social media? Any business case considers revenues that exceed costs and a succesful business model considers both the demand side and supply side of the product or service. Social media is primarily used today as a powerful direct and often viral marketing tool.

Social media like Facebook, Twitter and LinkedIn are now an ubiquitous part of life for many of us, but not for all of us. If you are a busy GP working for an HMO you be wired with an iPhone 4 in your pocket and an iPad on your desk, but inbetween babies with fever and senior citizens with congestive heart failure your are working on your next migraine, not your next tweet.