This is a very through article and review of issues around adoption of EMRs. It was interesting to see the comment related to customization of software that would potentially allow for a better fit with the office workflow. This is a very valuable concept but the challenge is where is user customizability most valuable and what should the choices be at each point. One of the problems is that some offices have become very good at doing things the wrong way. The other problem is that the foundation of the EMR application needs to be built to handle customization. To take full advantage of what EMRs could do a great deal of consideration should be given to how data collected once can be reused and repurposed. Having linkages between different components of the EMR are often neglected. For example when writing a prescription to be able to see the current problem list and selected lab results and current medications would be very helpful. The next thing would be to link the prescription to one or more entries in the Problem List. Without these things being in place the EMR would basicially function as an expensive computer based version of the paper chart. It could be much more than that.