David Blumenthal, M.D., trotted out all the usual arguments for the EHR during his lengthy presentation at the annual conference of the Medical Group Management Association annual conference-better communication, more informed decision-making, and far more efficient business practices. Once a skeptic about the value of EHRs, the national coordinator for health I.T. said he became convinced of the technology's value after seeing it in action at Massachusetts General Hospital, where Blumenthal once practiced primary care. "There would be no stopping a technology this valuable," he recalled thinking.

Now Blumenthal serves as the federal government's point man on EHR adoption. But not everyone is buying into the promise of EHRs. Javier Rincon, M.D., serves as regional medical director for Gateway Health Center, a 250-physician group practice in Milwaukee that has adopted an EHR.

Rincon uses the system, from Cerner Corp., to maintain his patient notes. But he says the technology can too easily upend the routines of a group practice, and create more work being shifted to physicians. What's worse is the government's meaningful use incentive program, added Rincon, a member of MGMA. Physicians in smaller group practices-the very groups the program targets-have no time to understand complex incentive programs, he contended. Rincon predicted the demise of the smaller group practice as a result. "The mandates mean more expense," he said. "And small groups don't have the staff to track all that."

--Gary Baldwin


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