Health It

We are writing on behalf of the American Academy of Family Physicians (AAFP), American College of Physicians (ACP), American Academy of Pediatrics (AAP), and American College of Surgeons (ACS), representing more than 180,000 physician members and the majority of our nation’s solo and small group physician practices. Collectively, these solo and small group practices provide 90% of Americans with acute care, disease prevention, and long-term disease management. They comprise the foundation of the U.S. health care delivery system.

The potential of health information technology (HIT) to improve the efficiency and quality of health care is well known and we applaud the President’s efforts to finally move American medicine into the digital age. Despite their front line role in health care delivery, solo and small group practices face unique barriers to HIT adoption. Below, we outline principles for HIT financing, health care quality improvement, physician autonomy, physician collectives, and HIT Stakeholders, which we believe will speed the adoption of HIT across the nation and most importantly, improve care for patients.

HIT Financing

The single greatest barrier for solo and small group physicians to achieve fully interoperable HIT is the substantial cost of acquiring the necessary technology (ACP, 2007). Although acquisition costs vary depending on practice size and HIT applications, they average $44,000 per physician, while annual maintenance costs average $8,500 per physician (Health Affairs, 2005 -Miller et al). In addition to these high financial costs, solo and small group practitioners must also bear the burdens of lost time, disruptive clinical process changes, billing problems, data loss, and long and uncertain payback periods. Reimbursement policies do not provide sufficient compensation for these physicians to assume such high costs and implement fully interoperable HIT.

The savings that solo and small group physicians realize from HIT would not...