It is typical that “early adopters” of change become more invested in the process and the outcomes and tend to work harder at perfecting the process. The largest flaw is the probable selection bias that arose in the small number (three) of self‐selected physicians who actually used the EMR. The principal conclusion, that hypertension management was better with physicians who chose to employ electronic medical records (EMR) compared to those who did not, could be questioned on scientific grounds because there are major flaws in the design and implementation of the study. It describes a system that has potential to improve care quality simply through better information formatting. While not a strong study from a scientific perspective, what makes Kinn's report potentially significant is the fact that it arose from a “real‐world” group practice environment. Provide a brief insight into two important issues whose interrelationship has been ignored for too long: the inability of the majority of practitioners to meet national standards in chronic disease management and the barrier caused by suboptimal record‐keeping in this failure. In this issue of JCH, Kinn and colleagues
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