For the most part, American doctors have resisted using electronic health records out of concern for patients’ privacy and fear plaintiffs’ attorneys will use the computerized data against them in malpractice suits. Peter Ehrnstrom, a dermatologist in Anchorage, Alaska, is considering investing in a system for his five-member practice, but says it’s typical for smaller physician-owned practices to lose 50% of their productivity while they get up to speed on the EHR system. Charles Cutler, an internist in Norristown, Pa., said, “I don’t think we’re going to come out on the other side of this endeavor financially better than the old system of maintaining paper records.” The major downside is that not all EHR systems are compatible with each other. A patch for one system to talk to another could cost upward of $10,000.

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