As I mentioned, I think there are two scenarios.

One: the occasional patient is leaving town, or seeing a consultant. I want to make that transition as smooth as possible. I will be selective, probably do some capsule summary.

Two: 2,000 patients need their records. As nice a guy as I am, the provider who follows me is going to have to do some digging. I'd like to send what I have in a chronological order, and make sure everything is there, including notes from consultants, labs, etc., but I can't afford to edit and label everything. There needs to be a purple button in the menu someplace that says "dump everything to disk".

And Jon, you again point out my biggest rant about the EHR: the lack of a common data storage standard and inability to cleanly import records. If I had been emperor, I would not have dreamed up giving money to doctors who adopted a random program; instead, I would have taken all of that money, and given it to Google or Microsoft and told them to build the EHR equivalent of Word or Excel. Then I would have given it away for free, and simply said "if you want to get paid by Medicare, you have until January 2012 to put this in place."


David Grauman MD, FACP
Flagstaff, Arizona