Our understanding of the value also is influenced by less scientific reports and testimonials of organizations that have implemented electronic health records and health information exchanges. These reports may lack scientific rigor, but they are accurate descriptions of value by those at the front line of care.

We need rigorous studies. They provide an important understanding of when and how to apply the technology and the nature of potential gains. But a growing chorus of successful experiences is, in many ways, more powerful than studies. A colleague telling another colleague that, "It was challenging but it was worth it," has an effect that is very real, very salient and very significant.

In the years ahead we can expect an electronic health record momentum that is the result of clinical colleagues talking to each other.