Particulalry in rural settings, access to specialty services, with an aging complex population is so unstable, fragmented and difficult that the related records are likewise and the impacts of these siloed systems stressful and diminish time and quality of care and connection with my patients. Furthermore the fundamental paradigm within the Interior Health authority electronic medical record system is predictably about collecting “measureables”, for management to analyze and attempt to interpret and engineer further budget efficiency and quality of care. These are of course totally inaccurate proxy-measureables.