Success of a national health information infrastructure depends on the widespread use and acceptance of electronic medical records in doctors' offices, according to a new federal legislative proposal released last week by the American College of Physicians that seeks to speed IT deployment in small group practices.
The college said the biggest barriers to IT adoption in these groups are high acquisition costs for the systems, which are upward of $30,000 per physician; staff time required to transition from paper-based record-keeping systems; and a lack of industry standards for interoperability of various systems.
The ACP proposal focuses on easing the cost burden on office-based physicians and setting standards to make the systems work together. The ACP estimates that half of all practicing physicians in the U.S. work in offices with six physicians or fewer.
"Tax credits, grant programs, loan programs and reimbursement incentives would make it possible for physicians in small practices to invest in the technology," ACP President Charles Francis, M.D., said in a news release.
The proposal was made just before David Brailer, M.D., the national coordinator for health information technology, released his update on a national IT strategy. The ACP called on the HHS secretary, through Brailer's office, to adopt the standards referenced in its proposal.
An ACP spokesman said no legislator yet had agreed to sponsor the bill but that Brailer's announcement was likely to pique interest.
"We're shopping it around on the Hill," said Bob Doherty, senior vice president of governmental affairs and public policy for the ACP. "I think there is a great deal of interest in trying to identify incentives to target physicians in small practices."
Incentives would include government grants, tax credits, additional Medicare payments and loan guarantees. Payment methods could include changes in the sustainable growth rate formula for physician services, care-management fees for users of IT to manage chronically ill patients and payments for e-mail consults.