Bert, actually I HAVE implemented are you sure you have the right patient? dialog/ workflow in an electronic documentation program I created for use at our community hospital. Folks were loading and doing a note on the wrong patient, and sending that note to the Electronic Record (wrong patient).
I believe it should be hard not easy to send a message on the wrong patient.
There seems to be a bit of a disconnect between the various controls on the main screen, such that you can be responding to a message that is not attached to the patient you see highlighted.
I may be misstating what is happening (out of ignorance, not animosity), hence my "opinion" qualifier.