Author reply: Steven A. Nissman - Electronic Health Records (Ophthalmology, Volume 116, Issue 5, May 2009, Pages 1018-1019)

Abstract

We respect the thoughtfulness that Dr. Nissman invested into his decision-making process, and completely agree with his observation that implementation of electronic health record (EHR) systems may present difficulties for small ophthalmology practices. The low rate of EHR adoption in our survey and others suggests that many practices have not been convinced of the benefits of EHRs. Furthermore, a recent survey of ambulatory care physicians in the United States found that adoption of EHR systems by small practices is lower than by larger ones.1 On the other hand, many advantages of EHRs, which were articulated in our paper,2 apply to practices of all sizes. Since publishing the results of our survey, the incoming Obama administration has proposed to invest $50 billion to support broad adoption of standards-based electronic health systems throughout the United States (Change.gov: The Office of the President-Elect. Available at: http://change.gov/agenda/technology_agenda/. Accessed November 27, 2008.). Medicare has instituted plans to reward financially practices that use electronic prescribing starting in 2009. We believe the proliferation of incentives like these will improve the cost-benefit tradeoffs for practices of all sizes.