Problems with the reliability and utility of electronic medical record systems has caused hardships for some small physician practices — costing them tens of thousands of dollars and limiting access to patient care. The House Small Business healthcare and technology subcommittee gathered testimony from some of these physicians at a June 2 hearing. Financial, legal and technological barriers have prevented smaller physician practices from investing in EMR technology, said Rep. Renee Ellmers (R, N.C.), the subcommittee’s chair. Nearly 25 percent of office-based physicians have fully functioning EMRs, according to a 2010 Centers for Disease Control and Prevention study. The American Medical Association has lodged concerns regarding the implementation ease and usability of EMR systems. Difficulties experienced during implementation have discouraged some doctors from using new technologies. The cost and time required to implement EMRs are big obstacles for small practices, said Andy Slavitt, CEO of the health information technology company OptumInsight, formerly Ingenix. Some may point to the meaningful use criteria for EMR incentives established by the Dept. of Health and Human Services as being part of the problem. However, questions regarding implementation aren’t so much about whether these standards are right or wrong, but about what should be the focus when EMR vendors design systems.