Martin, there are two major initiatives regarding the portability of health records. check out
www.healthvault.com, that is Microsoft's iteration. Google announced it's initiative here:
http://googleblog.blogspot.com/2008/02/google-health-first-look.html.Additionally the two initiatives mentioned above will force software vendors to produce and consume (export and import) a patient's entire medical record in a more or less standard format. This also means any EHR worth it's salt will have the capability to import a patient's record from one of these two vaults. Let's extend that thought a little further. There is no reason why as a doc who wants to switch EHR systems you would not be able to EXPORT ALL YOUR PATIENT RECORDS FROM ONE SYSTEM and IMPORT IT INTO THE NEW ONE!
The standardization that portability will bring will also be a boon for providers, freeing them from unproductive systems.
While I understand the desire to HAVE YOUR SERVER, I believe in the next 10 to 20 years will see a major increase in the use of "managed" systems. Reliability of connectivity is a major issue with that model. Many new docs, perhaps may not have the capital to invest in an entire office system. For the younger docs who grew up on YouTube, IPOD, having their data "managed" will not be such a psychological barrier. The notion of INSTANT OFFICE with no hardware to manage will go a long way.
This is just how I see the future.
