Why has the adoption rate of docs switching to EMRs diminished?  What happened to the logarithmic adoption curve the pundits theorized would occur right about now?  Are we resistant to change?  I argue absolutely not.  I embrace new technology in anyway possible.  I enter electronic orders, I view all XR and MRI on digital PACS.  I blog, I allow my patients email access and I have looked at many, many EMR systems.  I have also spoken to many physicians who have placed an EMR platform in their office.  They are not a universally satisfied group.  They find it takes longer to document, frustrates their staff and does not allow them to integrate to the hospital's system or to other offices ,etc.  Does it help billing, coding, and collecting? Maybe.  Personally, I am well versed in coding and billing and do not need a computer to tell me when I should bill a level 2 or 3.  I have a simple paper based cheat sheet that members in my group can utilize for coding purposes. Cost...less than a penny per page.  We have a rigorous coding compliance system in place to be sure we are billing accurately and spend time to educate docs and staff to be sure we remain compliant with new statutes. 

I do not see how my office (10 docs) would benefit enough to justify the enormous cost of the hardware, software and training necessary to implement an EMR.  Document management...probably a great idea... I am looking at these systems now.  But why should docs shoulder the entire cost of an EMR system that will ultimately benefit the insurance industry, big pharma,  and the data mining companies far more then it will ever benefit me.  I will most certainly revisit this when a platform is developed that allows a nationwide infrastructure to be properly constructed and executed.  Then the EMR/EHR/PHR concept will benefit everyone.  When information can flow seamlessly between offices, institutions and the payors, the efficiencies of scale and magnitude will make an investment on my part worthwhile for me AND my patients.