In December, the President's Council of Advisors on Science and Technology (PCAST) released a report on HIT. We've been referring to this as "the PCAST Report"
Wes Rishel recently blogged on one of the more contentious issues contained in the report.
Basically, the report calls for a move away from the "record-centric notion that data elements should 'live' inside documents."
Now, I am all for "re-using" information. I expect that we will extract information from these documents and will repurpose that data in ways that none of us can fully understand, today. Indeed, we will extract a Patient's Medication History, Problem List and Allergies from a clinical document and import that into a recieving EHR system to feed into its Clinical Decision Support logic. However, I do see the danger of "taking things out of context" (pun intended).
If we extract "atomic" data from clinical documents and feed this data into other systems and processes, we may end up with GIGO (Garbage In, Garbage Out). The likelihood that the downstream systems may not fully understand the meaning of the "atomic" data and will mis-use it is great.
I cannot explain this any better than Wes does. Please read his analysis.