The American Recovery and Reinvestment Act of 2009 included a requirement that Medicare-participating providers use electronic health records by January 1, 2014, or face financial penalties. Passed and signed into law just four weeks after the inauguration of President Obama, this expensive requirement, which had almost no public debate, forced hospitals, doctors, and clinics to move confidential patient information into digital format.

Twila Brase, author of the 2018 book Big Brother in the Exam Room: The Dangerous Truth about Electronic Health Records, says the electronic health record (EHR) is not what patients think it is. It interferes with patient care, is being used to violate patient rights, it makes sensitive data vulnerable to hackers, and it is threatening patient safety and medical excellence. She claims that what the government calls privacy rules are actually data-sharing rules. Furthermore, standardized treatment protocols and burdensome data-entry requirements are causing physician burnout and physician exodus from the practice of medicine. Government-mandated EHRs are an untested experiment that gives government and other self-interested parties outside the exam room significant control over private medical decisions.

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