I really appreciate the wonderful questions and answers that I have gotten on this question so far.
However, many of them have been focused on Doctors not understanding fundamental IT notions. This makes sense. Our community is often trying to convince various groups of doctors to make good leadership decisions, and focusing on the problems with that process makes it easier to answer "what do doctors not get". But I had two parts to my question. The other part was "What do (non-health) IT people not get about Health IT. To get us started I will start with the most shocking Health IT reality that I learned about when I first started in this community: The degree to which medical billing impacts the health IT process. I was shocked by the need for clearinghouses, that X12 was the "new" standard (dates me, I know) rather than a sensible choice like XML. I was shocked to see the arms race between insurance companies reasons for not paying and doctors justifying expenses... Then the degree to which that process locked us into billing ontologies that prevent more reasonable ontologies from flourishing. For those of us on the IT/Programming side, what was a painful/dramatic/profound lesson that you needed to learn about the way health IT operates? -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]