Additional costs may arise from voice recognition and fancy additional components. Unexpected costs are another concern. The software maintenance costs can also seem uncontrolled by physicians who prefer managing costs tightly. Every clinician fears the nightmare of having a computer with a patient's medical record totally crash and lock the information outside of the clinician's access. There are methods of getting around reliability issues through mirroring computers and doing fastidious backups of the data.
Confidentiality is compromised.
In the last several years we have all lost a significant amount of our privacy. The concern about keeping medical records confidential is highly significant in a large integrated delivery system whether the record is paper or electronic. Concerns about confidentiality are a significant issue needing to be addressed in any electronic medical record plan. The whole world is not doing it. The electronic medical records industry has had some growing pains and has advertised awesome capabilities but failed to have them fully developed.