There is a lot of buzz around the industry on the dollars available for EMR efforts. Big words and big ideas are swirling between interoperability, software certification, clinical quality, and data warehousing. Let's not forget the patient. I still believe the most transformational force in healthcare is the patient. A patient that can manage her own healthcare, understand her options, the comparative performance of her healthcare providers, and the cost of her healthcare choices can make a big difference. When we think of EMR efforts in 2009, let's not forget the patient. When we think of Wal-Mart, Microsoft's Health Vault, or Healthgrades, let's not forget that one of the greatest promises of EMR's is connecting the patient with her own healthcare. Why would small community physician practices want to use an EMR? Maybe because their patients expect them to in 2009, and now tthe doctors are getting a little financial help to do it. In 2009, patients want to see their last cholesterol online, request an appointment on-line, ask their doctor a simple question, or get their prescription refill on-line. Pretty soon, they may not want to go to a doctor that can't get with the program.