Let's face it, EHR disasters are part of the lore of health information technology. Handed down by word of mouth in hushed whispers around the water-cooler, these horror stories serve as cautionary tales for those implementing new technology. In a 2007 report by the Medical Records Institute, now defunct, 19% of respondents reported having deinstalled an EHR, while 7% were currently engaged in the process.

We've covered the trend of EHR deinstallation, the drama of Kaiser's HealthConnect, and the increased work flows and data entry woes of EHR implementations in general. But the stories below offer insight into the diversity of problems that can sour an otherwise profitable EHR rollout.

1. EHR data for dinner

Chris Rangel, MD, details the difficulties his practice faced after implementing an unproven EHR over the company LAN. The EMR began to backup the hard drive, instead of individual records, and it soon began overwriting it's own data. All records post-December 2008 were lost.

2. Keep this between us

In 2006, the Wall Street Journal reported on the story of Patricia Galvin, 51, who was denied disability after her insurer accessed confidential therapy notes. Ms. Galvin "discovered that when psychotherapy notes are mixed in with general medical records, the federal rules afford them no special protection."

3. CCHIT EHR is "unusable"

Valley Oak Orthopaedics of Davis, CA spent $50,000 on EMR software over a 4-year period in 2004, only to strip out the system after it "drained our productivity and became unusable," said Chris Taylor, Valley Oak Orthopaedics' Administrator. The prominent physician's practice chose SRSsoft's hybrid EHR software, despite it's lack of CCHIT certification.

4. Can you try back later?

Methodist Hospital in Indianapolis had to go "on diversion" and turn away ambulanced traffic for the first time in 100 years after a surge blew out Clarian Health's computer system, requiring hospital staff to enter patient information by hand. Care continued, nonetheless, but the amount of paperwork generated by the downed system, and the inability to look up critical patient records, hamstrung the otherwise busy hospital.

5. Your data is (not) safe with us

In 2008 the University of Miami informed its patients that "more than 2 million medical records [were] stolen from a van that was transporting the data to an off-site facility." In addition to social security numbers, the tape backups also contained financial information for some 47,000 people. Luckily, forensics experts concluded, it was most likely a random theft, and the thieves would not be able to access the encrypted data. But the trend remains unsettling.

Literature abounds on the costly mistakes providers have made attempting to install EHR systems. While there will inevitably be growing pains, it is a necessary system, that while imperfect, will hopefully live up to the high standards we all expect.