It's a back-end system that provides a centralized repository for all prescriptions. Frankel's key idea is that doctors don't have to call a particular pharmacy. They just tell the patient that a prescription is waiting in a database, and the patient can choose any pharmacy to go retrieve it. Retail pharmacies are scared to accept electronic prescriptions. Virtually no retail pharmacies are truly online.
Legacy systems are in place, and no one can talk to anyone else.
It's so far away. In addition to doctors and pharmacies, insurance companies are another key to making an online health-care system viable. They all need to move to the Net to make the whole notion of online medical records feasible. Whether or not they have a monetary incentive to change, they will eventually be forced to. And they know that.