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this medical blog focuses on the selection, implementation and meaningful use of electronic health records ( ehrs ) and other health information technology (health it) tools. health it tools like ehrs improve the quality of patient care when well-implemented and well-used, but there are many barriers to overcome. the 2009 arra/hitech legislation is infusing over $27 billion into health it over the next decade to address these barriers. for example, eligible physicians may qualify for up to $63,750 for achieving "meaningful use" of ehrs as defined by onc and hhs. the selection, implementation and safe use of electronic health records by physicians is particularly complex and is a key component in the rapidly growing field of medical informatics. the ehr barriers and challenges impact not only those who facilitate the implementation of clinical technologies, but also the clinicians who adopt and apply these technologies into their medical practice. in addition, patients in doctor offices are impacted by how well (or poorly) these technologies are integrated into a streamlined work flow. health it provides a broad range of topics for discussion, but as a physician author i will tend to focus discussions on the challenges faced by physicians, nurses and other clinicians, on the leadership roles available to physicians such as cmio and physician champion roles, on the selection and successful implementation of clinical technologies and on the meaningful use of ehrs to improve medical practice. some of the medical technologies discussed are electronic medical records (emrs), electronic prescribing, computerized physician order entry (cpoe), ambulatory ehrs, health information exchanges, secure messaging and the emergence of social networking and other social media tools. authored by matt murray, m.d.