My take on this is probably far-afield from the mainstream. I think the Dark-Side, firms like Google, Microsoft, and Oracle look at the confusion and lack of planning in terms of what the final EHR/PHR platform will look like and they simply drool. With hundreds of EHR vendors and RHIOs and RECs and standards groups all operating independently, all aiming at an undefined target, which group is best positioned to solve this platform problem, the Dark Side, or the Blind Side?

The Dark Side’s plans are underway and visible through their PHRs. Like the tip of an iceberg, I bet that most of what they are doing to own this space is presently unseen. Practice Fusion, if their product attracts enough customers will be devoured, or they will be ignored. RECs, RHIOs, Meaningful Use, Certification, a lack of standards, and no network are large red flags from the government saying “we don’t know where we’re going, but we’re making real good time.”

Here’s a reply I drafted at the request of Brian Ahier to his blog, http://radar.oreilly.com/2009/11/getting-personal-with-health-t.html

The Dark Side knows exactly where they’re going. They don’t need a network; they have one. The Internet. There are those who argue HIPAA and security. HIPAA and security can be more readily handled on a network that’s been up and running for twenty years and was built by the military than they would be under anything developed off the cuff under Washington’s leadership.

Now for the Deathstar issue–ownership of the data. The question is are ownership and possession one in the same? I bet they will not be. I’d also bet that five years from now somehow that Dark Side will have at least access to it. I can’t prove any of this, but I’d love to sit in on the strategic planning committees of the Dark Side. I bet some or all of this is underway. The Blind Side may be blind-sided.