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The country's health IT czar is urging small medical practices to overcome their resistance to change and "take the plunge" into electronic health records.

"Now is the time. ... Never again will the same level of resources and talent be devoted to helping providers make the switch to health IT," says Dr. David Blumenthal, who leads the Office of the National Coordinator for Health Information Technology (ONC), in a letter released Thursday. He nonetheless conceded that "EHR adoption and meaningful use are hard work and a big investment, especially for small primary care practices, where the vast majority of physicians work and where most of patient care is coordinated and documented."

That might explain a disparity in health IT adoption rates. Eight out of every 10 hospitals plan to achieve "meaningful use" with EHRs and apply for federal incentive money. Yet only four out of 10 office-based physicians have similar plans, says Blumenthal, citing data gathered by the National Center for Health Statistics, which is part of the Centers for Disease Control and Prevention, and the American Hospital Association.

A third of all medical practices plan to apply for federal incentives this year, including two-thirds of hospitals that intend to enroll during the first stage of the incentive program. Those hospitals seek to attain meaningful use this year or next.

"At ONC we are gratified that such sizeable percentages of physicians and hospitals intend to take the plunge - and to take the plunge sooner than later," Blumenthal says.

The meaningful-use incentives can mean millions of dollars to hospitals, and nearly $108,000 in Medicare and Medicaid payments to office-based physician practices. That's the carrot. The stick is smaller incentives for practices entering the game later and financial penalties for health-care providers that do not adopt EHRs within five years.

"The incipient surge in EHR adoption is galvanizing, especially for those of us who are committed to making the transition from paper-based medical records to EHRs as seamless and as successful as possible for every provider," Blumenthal concludes. "ONC will continue to offer encouragement and support."