Q: Where do you think we'll be with all this 10 years from now?

A: I told you that 10 years ago I thought we'd be further along than we are now (laughs), but I'm pretty confident that 10 years from now – I think it's going to take six to 10 years for us to get to somewhere of the proximity of the JASON vision. Which is to say that we have something that approximates data liquidity, across systems, first and foremost to improve patient care, and then, secondarily, to start to be able to aggregate data, at more than just a local level, to do research and population health.

I guess I'd just reflect on Bill Gates' quote, by now it's almost a cliche, but we always overestimate the effect of technology in five years and we underestimate the effect it's going to have in 10 years.

I suspect that's probably true if you take it in 10 and 10 blocks – that we overestimated how much we'd be able to accomplish in the 10 years since David Brailer and ONC was established in 2004. But I think now that we've got a foundation of EHRs, and we've learned a ton, and demand is genuinely there now, from the bottom up, in a way that wasn't there in the prior 10 years, I think we're going to be able to accomplish a tremendous amount over the next 10 years.
That's what I would hope: that we see ubiquitous nationwide networks – they could be independent networks, but they talk to each other – and the ability to have information aggregation in a way that allows us to get a better perspective on the pulse of where healthcare is: where are the hotspots, and how can we do better.

And then, finally, that will also enable patients to do much more than they can do right now, and think of healthcare as just like any other thing they do in their lives, like Facebook or Amazon. I think that's a reasonable expectation for us to have in 10 years.