[msandford]

It's the asymmetry of it. A person might have only one GP and one specialist. That is fairly easily managed. It's not good I agree. But it's MANAGEABLE.

Once there is a single large integrated database it's a HUGE target for people to creatively re-interpret the rules such that they can sell access to it. It's also a hacking target too since doctors tend to be a real pain in the ass about collecting all kinds of information that's not medically necessary but perhaps necessary for billing or in case you try not to pay your bill.

Right now this information is federated meaning that there's no one single point of failure. Hospital X's systems might go down, but Hospital Y's systems are still up. That means that unless something REALLY BAD happens across all the hospitals you're not going to die because a computer crashes.

I am far more on-board with good interchange protocols (Diaspora) than with one large centrally managed database (Facebook).