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Fostering Health Information Technology in Small Physician Practices: Lessons from Independent Practice Associations

NIHCR Research Brief No. 5
June 2011
Timothy K. Lake, Tricia Collins Higgins, Paul B. Ginsburg

As policy makers try to jumpstart health information technology (HIT) adoption and use in small physician practices, lessons from independent practice associations (IPAs)—networks of small medical practices—can offer guidance about overcoming barriers to HIT adoption and use, according to a new qualitative study by the Center for Studying Health System Change (HSC). Often because of inadequate technical and financial resources, small practices’ adoption of electronic health records (EHRs) and other HIT trails larger physician practices. Despite broader trends of physicians moving to larger practice settings, a sizeable share of physicians is likely to practice in small groups for the foreseeable future.

IPAs, which first formed in the 1970s to allow independent practices to accept risk-based managed care contracts, provide a useful model to examine ways of supporting HIT activities in small practices. As network-based organizations, the five organizations studied provided coordinated assistance with HIT activities to otherwise independent and relatively small physician practices. They also cultivated trusted and HIT-knowledgeable physician leaders to help less-technologically savvy clinicians. Additionally, the IPAs studied provided leadership to align HIT adoption with other IPA activities, such as quality improvement and pay for performance. IPA experiences with HIT adoption can offer insights for other entities charged with helping physicians in small practices overcome barriers to HIT adoption and use. And, given the proliferation of entities fostering HIT, the potential for overlapping efforts exists, increasing the importance of local planning, stakeholder communication, and ongoing assessment of how best to align and coordinate efforts.

This article can be accessed at the National Institute for Health Care Reform Web site.





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