"In health care, changes in the way we organize our work will most likely be the key to improvement. This means training students and physicians to focus on the patient despite the demands of the computers. It means creating new ways to build teamwork once doctors and nurses are no longer yoked to the nurse’s station by a single paper record. It means federal policies that promote the seamless sharing of data between different systems in different settings."

I think the author is right about the problems, and these solutions seem sound. These are the kinds of things ossified institutions always say, and they're actually usually right (e.g. Bill Gates's prescient Internet Tidal Wave memo which predicted the ways in which Microsoft would fail to become a dominant player on the web, or the peanut butter memo at Yahoo).

The trouble is that actually implementing changes like these at an incumbent institution is hard. Really hard. So hard, in fact, that failure is overwhelmingly the rule. In most industries, the way that plays out is that incumbents fail to change, new competitors emerge with the new processes baked into them from the beginning, and they then kill the incumbents. A few years later, those new folks ossify and then themselves get killed by the next wave. And so on.

A healthy industry offers all its players a choice: "Evolve or die. Do whichever one you want, but one of those two things will happen." There's no third option, "Do your best to evolve". The institution succeeds at changing or it dies, and that's all there is to it.

The trouble in healthcare is that incumbents do get that third option. And the reason they get it is that for the most part, there are no new competitors to kill them off.