Electronic health care records offered the promise of cheaper, safer and better. There would be a reduction of unnecessary tests. There would be a reduction in medical errors. It would all lead to cheaper health care. Such claims were backed by very small studies, but more often rhetoric (coming strangely enough from the technology companies). Alas, the small study evidence did not generalize. While EHRs are crude in Canada, evidence from other jurisdictions suggest the promises are not being fulfilled overall. The contingent factor is the culture of the organization. Those organizations with the culture and incentives to use the technology to change practice behaviour are more likely to accrue benefits of cost, safety and quality. But it would appear such organizations are the small minority.

So in the end, technology can create the demand for more administration with little impact of quality and cost = extra cost. And power still determines how resources are allocated, not data.