We’re still a long way from great electronic medical records, but it seems like we’re not even picking off the low-hanging fruit. I was at the VA last month (which, among some unofficial surveys of many physicians, is by far the best electronic medical record out there right now), and saw a patient with gout. He had had an acute attack 3 weeks ago, after his physician had put him on hydrochlorothiazide, a medication for hypertension, but one that can also cause attacks of gout, because it increases uric acid levels in the body. Now, he had a diagnosis of gout listed officially in the computer, and he was taking two gout medications. The physician made a mistake, for whatever reason, but the computer should have figured it out. We’re still better than computers, but I’d be happy to have one double-check my work in the background.