Metamorphosis of medicine in the United States: a carrot and stick policy of electronic medical records.

practices, electronic medical records (EMRs) or electronic health records (EHRs) are the number one and most complex issue for all medical professionals, specifically independent practitioners (1-14). In fact, Dentzer (2) reported that many fans of the American Recovery and Reinvestment Act (ARRA) or the “stimulus” package, enacted in February 2009 (9), might not realize how much went to health care. For each $5 in 2009 ARRA spending (9), $1 was allocated to the health sector, mainly health IT. The primary interest of policy makers and a key provision was the Health Information Technology for Economic and Clinical Health (HITECH) Act, aimed at bringing US health care more fully into the so-called information age. Policy makers, supporters of EMRs, and IT providers and people managing information technology in health care continue to tout the advantages of EMRs, including improved care and cost savings. However, the transition to electronic medical records has been very expensive and resulted in a variety of challenges (1-12). This manuscript explores how electronic medical or health records are leading the metamorphosis of contemporary and independent medical practice, along with implications for the future of health care in the United States with incentive programs and financial penalties utilizing a carrot and stick policy.