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November/December 2011

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Exemption of Small Practices From EHRs

Many EyeNet stories like “EHRs Got You Down? You Are Not Alone” (Opinion, July/August) and “EHRs: What Is the Return on Investment?” (Practice Perfect, January) tout the benefits of electronic health records (EHRs). They also ignore the time-wasting and financial burdens that can cripple small and solo ophthalmology practices.

The Academy’s political action committee needs to make a stand to exempt small practices from an obligation to implement EHR systems. Legal precedent has been set. President Obama himself has exempted thousands of businesses from the mandates of the latest health care reform because of financial burdens. Moreover, Medicare exempts small practices from e-prescribing—although the exemption number of annual written prescriptions needs to be raised.

Accusations of Luddite mentality may be true; however, we must face economic realities. No specialty has embraced technology more than ophthalmology. Many laser centers—the epitome of advanced eye technology—have closed, driven into bankruptcy by technology costs.

I encourage EyeNet readers to contact both members of Congress and the Academy to obtain and secure exemption from the onerous EHR bureaucracy.

Christopher Lyon, MD, PhD   
Newport Beach, Calif.   


Editor’s Note: For a discussion of the Academy’s reimbursement and quality-of-care priorities relative to the health care reform law, visit


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