I think the recent work of the NHIN Direct implementation teams has been amazing. But I think that by implementing, all of the teams have succumbed to different extents a common software developer error. They are implementing rather than empathizing with their users.

There are two groups (possibly three if you count patients, but I will exclude them from consideration for just a moment) of potential NHIN Direct end users. But before we talk about that, I would like to talk about Facebook and Myspace.

Or more accurately I want to remember the controversy when the Military chose to block users of Myspace but not Facebook. This caused quite a stir, because at the time, Myspace was very popular with the high-school educated enlisted personnel, but Facebook, which even then was "higher technology" was more popular with the college educated Officers. Controversy aside, it showed a digital divide between different types of users.

Ok, back to Healthcare IT.

We have something strangely similar to this in the United States with the level of IT adoption with doctors.

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