The government's $75-million, 10-year project to put every American's vital information on electronic health records faces a hurdle long known to health plan officials — the possible lack of physician buy-in.

That's one of the conclusions that might be gleaned from an issue brief by Mathematica Policy Research. In its literature review, researchers note that large physician groups and hospitals seem to be leading the charge in adopting EHRs.

"However, the extent to which small physician practices — those made up of eight or fewer physicians, representing nearly 80 percent of all physicians in the United States — have adopted EHRs nationally remains unclear," the authors state.

Lorenzo Moreno, author of the issue brief and a senior health researcher at Mathematica, puts it this way: "Our review suggests that use of EHRs by physician practices is still modest among solo or small-group practices."

That could change, he adds. "Providing appropriate financial incentives to providers, fostering the development of standards and networks allowing EHR systems to communicate nationwide, and addressing legal barriers to secure exchange data will move this process forward."

Allowing EHR systems to communicate nationwide is one of the thrusts of the government's efforts.

David Brailer, MD, PhD, the national coordinator for health information technology, told a meeting of the American Medical Informatics Association in April that health information technology has to be standardized even though currently there is no standardization process in place.

A range of people in health care give Brailer a lot of credit for motivating the myriad of vendors and IT-advocates to meld their efforts into a more cohesive set of collaborative initiatives.

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