The cost, physician practice size, and lack of technical resources still present barriers for small healthcare providers in adopting electronic health records and participating in the meaningful use incentive program. Solo practitioners and small practices find it difficult to locate a lender willing to offer them an unsecured loan, said Sasha Kramer, MD, a solo practitioner dermatologist in Olympia, WA. Others who try to finance their electronic health record system with the vendor have no leverage in negotiating terms because of their limited market share. Kramer was among public and private health IT experts and physicians who spoke at a June 2 hearing of the House Small Business Committee's health care and technology subcommittee.