I would not accept EMR unless my records are encrypted and can only be unlocked with a smartcard that remains in my posession. Or something close to that.
So (hope it never happens) if you have met with a bad accident, the first responders must break in to your house, call lockpickinglawyer (youtube lock picking guy) break your safe open, retrieve your smart card, then bring it to hospital and start your treatment? And I thought time is very critical. Privacy is important, but its implementation must be reasonable, come on.
So... You don't want your doctor to be able to view your records without your physical presence?
And in some cases, you might not even be in a condition to give the smart-cards (eg. coma, stroke)
You're often in that condition anyway. If you're taken to hospital in a coma or stroke condition, they won't necessarily know who you are nor will you be able to consent to any procedures. They proceed on good faith in that case.