What's missing from the list? The business case, though to be fair, it still is a concern. And, while HIEs are not so widespread and mature as to collect decades-worth of ROI breakdowns, there is anecdotal evidence of savings.
If physicians' perspectives of inoperability and infrastructure challenges can be overcome, then stand-alone physician groups may be more apt to join HIEs. That group was less likely to join an HIE.
Janet Marchibroda, Chair of the Health Information Technology Initiative at the Bipartisan Health Center, which worked with the Doctor Helping Doctors, says consolidation may force smaller practices to evolve, technologically.
"I think that there's a lot of evidence that indicates that the adoption of electronic health records is difficult for small physician practices because it can be capital-intensive. That may be a driver for a physician practice to either join with other, larger practices or to utilize an EHR system provided by a hospital," she says.
Marchiboda also says stage 2 meaningful use requirements will help overcome the obstacles most physicians named.
"The good news is stage 2 actually has very robust requirements to certify EHR technology. Technology being federally certified before it can be sold for clinicians to use will help address concerns about interoperability," says Marchiboda.