That sounds promising, right? So why aren't electronic health care transactions the rule instead of the exception? Mr. Gandolfo and Mr. Wilkins both stated that as a nation, we're moving in that direction, but there are some hurdles: Most doctors' offices are not yet electronically enabled; HSA adoption is still fairly low; and most of all, there's a lack of interoperability among all the various health IT systems. "We need a solid, common infrastructure to do this on a wide scale, and we're very, very far from that right now," Mr. Wilkins said.