The vision of computerized medical record has not been achieved in spite of major progress in understanding the process of record keeping and revolutionary improvement in computer capabilities. This article discusses the problems inherent in achieving a universally available patient record. The roadblocks include lack of buy-in by providers and their institutions, adoption of common terminology, universal computer standards and a national infrastructure to promote the dissemination of health care records. The influence of the internet on the adoption of electronic medical records and some views for the future are presented.
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