Physicians in small offices who handle the bulk of patient visits have special financial needs when it comes to adopting electronic health record systems, even with the prospect of a multibillion-dollar federal subsidy program for EHR purchases, according to testimony at a congressional subcommittee hearing Wednesday.
Rep. Kathy Dahlkemper (D-Pa.), chairwoman of the Regulations and Healthcare Subcommittee of the House Small Business Committee, said 80% of all outpatient visits take place in medical practices of 10 or fewer doctors. Meanwhile, 57% of large practices with 50 or more physicians have EHRs, but just 13% of solo practitioners do.
"The initial investment required for HIT is enough to make smaller practices think twice and, for many physicians, simply puts this technology out of reach, Dahlkemper said. "This 'health IT gap' between large practices and small practices is particularly significant when you consider that the vast majority of treatment occurs in small doctor's offices."
Dahlkemper said she plans to introduce the Small Business Health Information Technology Financing Act to provide small physician offices access to Small Business Administration loans to help with the upfront costs of EHR installations, estimated at nearly $100,000 for a three-physician practice.
For many physicians, its a big enough hurdle to stop them from investing in healthcare IT, Dahlkemper said. Even with the stimulus law incentive payments, many practitioners will find it difficult to make the necessary investment, she said.
Physician David Blumenthal, the national coordinator for health information technology at HHS, testified that a portion of the $2 billion appropriated by the stimulus law for his office will be used to set up and fund a regional healthcare IT extension service that will give priority to individual and small group practices. HHS hopes to get the extension programs running this year, he said.
We understand that small practices carry an extra burden, Blumenthal said.