Either HHS or Congress must restore the rights of patients to control the flow of their healthcare information. This is a right that HHS, to a large measure, trampled when in 2002 it revised the Health Insurance Portability and Accountability Act privacy rule to allow the electronic movement of patient records for "other healthcare operations."
In the seven years since, I've heard every argument against consent—how hard and complicated it would be to restore it, what restoration would do to work flow, public health, and research. I take these points at face value, even though some who argue against consent have a direct financial benefit in maintaining the current consent-free environment. Still, I concede that it won't be easy to walk back consent. It will require technology, thought, public debate and money to protect privacy and preserve the promise of health IT. It, like democracy, will be an altogether messy process.
But it doesn't matter how easy or tough or messy it's going to be. It has to happen.