"Ultimately small and solo health practitioners are small businesses. Similar to small businesses everywhere, one of their biggest challenges is accessing affordable capital," Dahlkember said.
In the last few months, I've heard from several physicians that the lag between the initial investment in an EHR system and when physicians actually will start receiving incentive payments is one of the biggest remaining obstacles to EHR adoption. A few thousand dollars in extra reimbursements in 2011 or 2012 does little good if a practice can't afford the upfront costs of implementation today.
This legislation is a good first step. But the focus on small practices needs to persist throughout the process—when meaningful use is defined, when certified EHR systems are selected, and when reimbursements are potentially cut in 2015.
The bigger physician groups already have EHRs, and if they don't, implementation is at least manageable. It's the smaller practices that will determine whether or not this ambitious shot at digitizing healthcare succeeds or fails.