Fuld predicts that the complexity and cost of implementing EHRs will overwhelm “hundreds of thousands of doctors in small practices,” prompting them to combine with group practices. And, if this business forecasting proves correct, expect health IT companies like Cerner, Allscripts, and Epic to become acquisition targets for Fortune 500 giants like Microsoft, Oracle, and I.B.M. and the already-familiar McKesson. In an ever-changing EMR field, this doesn’t have the promise of stability, even with ever-progressing CCHIT  certification. But, on the other hand, this might have a promising end-result, allowing for lower costs and better technology for clinicians.

Speaking of EMRs, one state medical group, Maryland’s MedChi, will urge the American Medical Association at a meeting this week in Chicago to put pressure on the feds to delay or eliminate penalties for doctors who don’t adopt electronic records by 2015, the mandated deadline. The cost of launching a health information system can be as much as $80,000, a burdensome price tag, especially with lower reimbursement rates and high malpractice premiums.

But despite all the naysayers, dire predictions, and delays, using an EMR versus paper, in the end, is a no-brainer and inevitable. And deep adoption by physicians is critical to the success of any EMR implementation.