There is little doubt that the big story in health IT circles continues to be the CPOE study in Pediatrics which found an alarming increase in mortality rates at Children's Hospital of Pittsburgh. Those conclusions generated a fierce debate as to whether we need CPOE systems, and whether EMRs can be adapted for critical patient care situations. Yesterday, leading patient safety expert Bob Wachter likened the phase medicine is undergoing to one similar to that in aviation in the middle of last century--from independent test pilots to team players--as described in Tom Wolfe's The Right Stuff. Even though no pilot would go back to doing things the old way, it was not a painless transition. What is clear is that the introduction of new technology requires a detailed examination of virtually every care process, and in some cases the benefits can only be realized if the process is changed to fit the technology. That is a very complicated sell. - Matthew