Recent passage of the American Reinvestment and Recovery Act (ARRA) increases pressure on health care practitioners and organizations to implement currently available electronic health records (EHRs). Research and experience gained to date show that such implementation efforts are difficult, costly, time-consuming, and fraught with many unintended consequences.1 Evaluation of these systems after implementation suggests that they do not routinely meet safety standards of other safety-critical industries.2 The aggressive timeline proposed in the ARRA bill means that a large number of practitioners and health care organizations will soon be attempting a monumental feat without the time or ability to customize these systems to their local workflows.3
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