As someone who questioned the validity of the results of the McCormick study, I would ask Hebel et al. the same questions re maturity of software, training of providers, workflow design, and economic incentives for over- or under- ordering of tests. I am also curious if Hebel et al. looked at actual use of the internal HIE - and did not simply assume that because it was available that it was used.

As I articulated in my critique of McCormick, supporters of health IT should not be unduly distressed by the seeming negative results of retrospective correlative studies; nor should they be overly excited by similar studies which appear to show benefit.

What would make this study more interesting; redo the analysis using the lens of appropriateness. Thus, did providers reduce unnecessary testing because within the workflow of ordering new tests, they saw recent results that made additional appropriate testing unnecessary.