Are a patient's symptoms more likely to get digitally documented into an electronic medical record at the convenience clinic inside Wal-Mart than at his or her own doctor's office? Possibly.

The emergence in the last few years of convenience health clinics operated in the stores of retailers such as CVS, Walgreen's, and now Wal-Mart has brought with it an unexpected twist.

Besides providing quick tests for strep throat and prescriptions for antibiotics by nurse practitioners working in small spaces set up somewhere between the cosmetics and pet food aisles, these retailers are deploying technology tools in their clinics that most doctors still lack in their offices -- e-health records and decision-support systems.

It's estimated that fewer than 20% of U.S. doctors have deployed e-health record systems in their offices, despite the urging by health-industry experts and government officials, who have been spotlighting IT in recent years as important tools to reduce medical errors and costs.

When it comes to the largest chain retailers, these clinics are typically run as division of the retailer or are operated by a third-party health-services provider (such as a hospital group) but co-branded with the retailer.

For instance, MinuteClinic, which was acquired a few years ago by CVS, is operated as a subsidiary. So, MinuteClinic either owns and operates clinics or manages them for another company, depending on various state regulations. On the other hand, the new "The Clinic At Wal-Mart" sites are actually owned and operated by third-party health care providers that are co-branding their clinics with the Wal-Mart brand at Wal-Mart's stores.

Wal-Mart unveiled the first of these co-branded clinics earlier this month in Arkansas and has plans for more than 400 by 2010 in Atlanta, Little Rock, and Dallas, including some rebranding of the approximately 60 clinics that currently operate in Wal-Mart stores.

Right now, Wal-Mart also has about 55 in-store clinics that are leased and operated by independent companies. However, a Wal-Mart spokeswoman said that as those leases expire, Wal-Mart hopes to change those sites over to the new co-branding model.

As part of this push, which could end up with Wal-Mart opening more than 2,000 clinics by 2014, Wal-Mart said it signed a letter of intent to work with RediClinic and local hospital systems to open co-branded walk-in clinics in 200 Wal-Mart Supercenters. The retailer has also signed a letter of intent to partner with St. Vincent Health System, part of the Catholic Healthcare Initiatives system, to open four co-branded clinics in Little Rock.

RediClinic also runs about 30 in-store clinics under the RediClinic name elsewhere and uses proprietary e-health record software for patients at those sites, said a RediClinic spokeswoman.

However, as part of the Wal-Mart co-branding deals, the retailer is "requiring" that the operators of its clinics -- including RediClinic -- use e-health record and practice management software from eClinicalWorks, a privately held vendor in Westborough, Mass. "Wal-Mart wants to be consistent with all its clinics," said the RediClinic spokeswoman. A Wal-Mart spokeswoman confirmed the requirement for eClinicalWorks software to be used in its clinics but declined to elaborate.

An eClinicalWorks spokeswoman said Wal-Mart attorneys have requested that the company not publicly discuss its Wal-Mart relationship. While eClinicalWorks, which posted revenue of $60 million last year, is tiny compared with e-health record vendors like General Electric and Epic Systems, eClinicalWorks is also playing a key role in a few high-profile regional e-health projects involving multiple health care providers, including the Massachusetts eHealth Collaborative, which has hundreds of doctors using eClinicalWorks software in their practices.