Making long-term decisions in the middle of a storm is never a good policy, and we are certainly in the teeth of an economic hurricane. So you may not want to think about it, but it's likely that one of the casualties of this storm will be your way of handling patient records, if you're like the majority of medical practices.

It's now clear that health-care reform is one of the three key priorities in the nation's capital. And one of the keys to health-care reform will be dragging medical practices into the digital age.

It was probably nine years ago that we first addressed the topic of electronic health records. EHR was the wave of the future. EHR remains the wave of future. As the years have passed, it started to become apparent that most physicians were content to let EHR always be the wave of the future. The expense, both in money and even more so in time, the complexity, the lack of national standards, the lack of a gun to your head, all of these things have contributed to the snail's pace of adoption of EHR. And none of these is going to be solved by the stroke of a pen in Washington.

The preferred method of enticement in this situation has been the carrot rather than the stick. Anyone who's participating and looking for his payment from PQRI can tell you how well the carrot phase of that program is working.

With patient volumes down and revenue tight, it's hard to think about investing in the perennial wave of the future. But this time, it may not be possible to avoid. It's a good bet that even if the myriad challenges related to connectivity, compatibility, cost and time demand are resolved (and has there ever been a bigger if than that one?), it's going to take a lot more than an incentive check to make physicians buy in to the change in culture that EHR entails. Major technical support on the front end, beyond the enticement of extra dollars, will be a minimum requirement. If it hasn't started already in your practice, you can be sure that the drum beats from EHR providers will soon be coming fast and furious. When it comes to EHR, like it or not, the future is coming soon.

If Yogi didn't say that, he probably meant to.