While the New Jersey Health Information Technology Extension Center has reached a milestone in getting primary-care physicians to implement electronic health record systems, the head of a physicians group said increasing costs could halt further adoption in the state. "With the costs and the evolution of medicine for primary care, maybe solo practices may no longer be able to exist," said Dr. Salvatore Bernardo Jr., president of the New Jersey Academy of Family Physicians. According to Donald H. Sebastian, chairman of the NJ-HITEC and senior vice president for research and development at the New Jersey Institute of Technology, a $23 million grant awarded to the center from the U.S. Department of Health and Human Services in 2010 has allowed it to assist 5,000 primary-care physicians in adopting digital recordkeeping.