WASHINGTON – A representative of the largest medical specialty organization in the United States told Congress Thursday that mandating the use of healthcare IT in the absence of positive financial incentives for physicians would likely drive small physician practices out of business.

"Without adequate financial incentives, small practices and their patients will be left behind the technological curve," said Yul D. Ejnes, MD, a member of the Board of Regents of the American College of Physicians and chairman of ACP's Medical Service Committee. Ejnes testified at a hearing of the House Ways and Means Committee's Subcommittee on Health.

Ejnes acknowledged that the benefits of widespread adoption of interoperable healthcare information technology would be significant, leading to a higher standard of quality in the U.S. healthcare system. But he noted that much of the savings from physician investment in healthcare IT are realized by public and private payers, not doctors themselves.

"Acquisition costs can average up to $44,000 per physician (and) the average annual ongoing costs are about $8,500 per physician," said Ejnes. "For many of these practices, the 'business case' for making such a large investment simply doesn't exist."

Ejnes, a general internist in private practice in Cranston, R.I., told the subcommittee his 50-physician group practice has an electronic health record system, but has received some support from a "forward-looking" private payer.