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Letter: EHR requirements will ruin small practices


A reader shares a letter written to the Center for Medicare and Medicaid Services about the hardships electronic health records impose on small medical practices.

Editor’s note: The following is excerpted from a letter the writer sent to the Centers for Medicare and Medicaid Services and is reprinted with the permission of the writer. 

I work in private solo practice as an internist in an underserved area. Five other internists left this area recently, and currently I am the only internist here.

EMR [electronic medical record] software slows down my work. This is bad for patients and for my practice. Perhaps it can be useful for statistical purposes that you need for practice evaluation.

I have asked many other physicians about EMR software and none of them recommend using any software available at this time. On the other hand, if you consider EMR to improve medical practice, why do you penalize [physicians] for not using it? Maybe it is just your excuse to cut reimbursement.

Each health professional would like to be maximally efficient, but available EMR software does not serve that purpose.

It is clear that all health professionals are forced to use EMR, but you should reconsider having some exception with small practices in underserved area, where investment in EMR is not cost-effective. For example, all private businesses with less than 50 employees are not required to offer health insurance, but every medical practice is required to show meaningful use of EMR or will be penalized.

My husband is a software developer and can make highly efficient EMR for my practice. This is not cost-effective either, since EMR needs to be certified.

I have never heard that any other software needs continuous certifications and of users paying a penalty for not using such software. Does any bank or insurance company pay a penalty for not using software? Do any other small private businesses excluding medical practices pay a penalty for not using software?

If current law remains in effect, it will certainly ruin small practices. I hope you will seriously reconsider the possibility of hardship exceptions for small practices.

Smiljka Stojanovic, MD

Americus, Georgia

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