HealthLeaders Media: In all the debate about Meaningful Use, it seems to me that the incentives don't encourage knowledge transfer from the successful innovators, like Intermountain, to those who are following.
Berwick: We're just barely in Phase 1. The concept of meaningful use is going to grow. What doctor in the end would not want access, if it were technically available, to the answer to the question, Who does the best at this, or What does Mayo think, or Where's the best science? We're just in an adolescent moment in terms of evolution of that kind of knowledge transfer. Right now, my daughter is a second-year resident in medicine at the Brigham hospital in Boston. When I was in training, the message was, put it all in your head. Get it in your head. Read it, memorize it, and then spout it out at Rounds. They carry their iPhones on Rounds. So a question comes up, and they're using their iPhones and iPads right there to get the information. Why would they store it in their head if it's in the world? That's a basic human factors design idea. Knowledge in the world is more useful than knowledge in the head. Young doctors and nurses are coming from a totally different mindset about access to knowledge.