A Category 5 hurricane destroying millions of paper medical records didn't jolt many doctors or hospitals into embracing electronic health records. So does a fresh executive order from President Bush pack much wallop? Unfortunately not.

A year after Hurricane Katrina, the hoped-for uptick in digital medical records adoption hasn't happened. A September 2005 study found just 14% of group practices had e-records, and people in the field haven't seen much change. "We just didn't see an uptake [after] Katrina," says Mark Roman, EDS's health care global leader.

Bush signed an executive order last week requiring federal agencies that sponsor or administer health programs to adopt and use interoperable, standards-based IT systems, which should spur things in the right direction. The order doesn't reach those most reluctant: doctors who pay for the systems and deal with the IT headaches but don't get extra money for using them. "Even if the software works in the way it's supposed to work, the benefits of those systems go to the payers and the patients," says Stephen Davidson, professor of health care management at Boston University.

The feds aren't giving this issue urgent care. The Senate and House each passed health IT bills but haven't struck a compromise. The national health IT coordinator position, created by an executive order two years ago, has been vacant since spring.

Bush in 2004 set out a goal for "most Americans" to have e-health records in 10 years. Tick, tick.