The New York Times today has a story about Electronic Health Records and the Obama Administration's attempt to get more doctors to use them. 

It is scarcely surprising, then, that only about 17 percent of the nation’s physicians are using computerized patient records, according to a government-sponsored survey published last year in The New England Journal of Medicine.

“This is really not a technology problem,” observed Erik Brynjolfsson, an economist at the Sloan School of Management at the Massachusetts Institute of Technology. “It’s a matter of incentives and market failure.”

That market failure is a principal target of the Obama administration’s plan. A main feature of the legislation calls for incentive payments of more than $40,000 spread over a few years for a physician who buys and uses electronic health records. But the technology is just a tool, one that needs to be used properly to improve health care.

This is something I'm intimately familiar with.  As such I can tell you the Obama administration is largely missing the point.  There is one thing that is keeping most doctors from adopting electronic records and that's fear of the Health Insurance Portability and Accountability Act of 1996 (commonly known as HIPAA)

HIPAA was originally intended to help keep medical records secure and confidential but it's vagueness in combination with its unrealistic documentation requirements has created an environment in which people are scared to go digital. 

Because if you're a doctor in a small office one HIPAA violation could cost you everything.  Yet if you ask 5 different HIPAA experts what specific security precautions you are required to take I guarantee you will get 5 different answers.  Because the law is vague and written in "government speak"

This is why the Obama Administration's solution to give money as an incentive won't work.  No one is going to risk their entire career for $40,000 spread over several years. 

Especially when even the requirements to get that money are vague...

So the legislation states that physicians will be paid only for the “meaningful use” of digital records. The government has not yet defined that term precisely. While the long-term goal is better health for patients, that can take years to measure. Consequently, many health experts predict that the meaningful use will be a requirement to collect and report measurements that can be closely correlated with improved health. Examples would be data for blood glucose, cholesterol and blood pressure levels for diabetes patients.

If the Obama administration is serious about getting doctors to use technology what they need to do is create specific guidelines based on the current technology.  Essentially they need to create an environment where a doctor can hold a list of HIPAA requirements up against a software vendor's feature list and be confident that the software they're looking to buy is HIPAA compliant and will not put them at risk.

Only then will you see doctors starting to make use of technology in their practice.

Addendum: The end of the NY Times article mentions the creation of "regional health IT extension centers" which would help facilitate doctors move to Electronic Records.  These would be modeled after a New York program from a couple years back. 

These centers aren't a bad idea but the problem is the New York project being referenced cost $27 million dollars and by their own admission only got about 1,000 physicians online.  That's $27,000 per physician (which, under the Obama Administration plan would be in addition to the $40,000 incentive given to the physician). 

Given the cost I don't see that as a realistic solution.