This report from the Congressional Budget Office (CBO) was widely reported in the press today. The press has mainly focused on the report's skepticism about earlier estimates of greater than $40 billion/year savings from broad national electronic health record adoption. This certainly is going to remain a point of controversy but other questions raised by the report merit broader debate. Do EHR's reduce duplicate ordering of tests and reduce adverse events in the outpatient setting? It has been my own intuition that it does, but this CBO report points out some contrary evidence. It seems that these questions constitute a useful research agenda for the medical informatics community which should be further pursued, in many healthcare delivery settings.