The Kabuki we see in the transition to electronic health records obscures two obvious and fundamental issues: The nature of the confidentiality privilege for electronic records maintained by patients instead of doctors; and The right to avoid self-incrimination when medical records contain information that might result in criminal prosecutions.
Both issues deal with the legal rights patients have in their medical records. To be clear, this is not the same as the patient rights granted under HIPAA or the types of private sector commitments to not abusing use of medical records. We seem to have a grasp on these finer points.
Instead, there seems to be little enthusiasm for dealing with the more mundane non-health related issues that arise when patient data meets the court system and the criminal code. These more concrete and practical issues are the real posers.