Hundreds of public comments on the proposed Stage 2 electronic health records meaningful use rule from the Centers for Medicare and Medicaid Services now are online at, by entering CMS-2012-0022 in the search box.

One of the comments is from Rep. Renee Ellmers (R-N.C.), an R.N. who practiced with her physician husband in a small family practice before being elected in 2010 and who serves as Chair of the House Committee on Small Business health care and technology subcommittee.  

“I am concerned that the Stage 2 goals may be too ambitious for some small or solo practice physicians to meet,” she wrote in her comment letter. “This is a critical issue since, according to the American Medical Association, 60 percent of office-based physicians work in practices of fewer than ten doctors. I continue to be concerned about physicians in solo or small practices who do not have, and who simply cannot afford, health I.T.”

Ellmers referenced congressional testimony in June 2011 from physicians who have found the cost and time to implement I.T. a significant burden, even among those who believe it would benefit their practices. She urged CMS to permit hardship exemptions for practices with five or fewer physicians and those over 60 years of age and nearing retirement.

“As I have outlined here, many of these physicians simply do not and will not have the resources to purchase and maintain health I.T. systems.”

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