The biggest barrier to electronic health record (EHR) adoption has always been the upfront cost of implementing the system and the productivity lost during the learning curve. The rapidly changing healthcare landscape, however, may make cost the reason why physicians adopt health IT. Come again?

The Centers for Medicare and Medicaid Services (CMS) recently announced a 21.2 percent 2010 pay cut for physicians participating in Medicare. That much of a cut in this kind of economic environment is catastrophic. When any business takes a revenue hit, it compensates by slowing its spending. At the same time, it also looks for efficiencies. Enter health IT and EHRs. The promise of the federal incentive dollars help to blunt the sting of the upfront cost. Now with the 2010 pay cut, physicians now need health IT and EHRs to create efficiencies and potentially be the vehicle for other revenue streams.

I didn't make this all up. The scenario is backed up by an online survey of 200 provider respondents conducted in October by IVANS, Inc., an IT services company. More than 30 percent of the respondents said they would use technology to help offset the impact of the proposed Medicare payment cuts, according to Charles DeNicola, CEO of IVANS. "From their perspective, technology is not simply a way to cut costs but, more importantly, to increase efficiencies to maintain the quality of care to their patients," he said.

It makes sense. Health IT and EHRs can create administrative efficiencies and bring revenue stream opportunities to bear. It's worth the upfront cost, especially with the promise of reimbursements after achieving meaningful use. The way meaningful use is shaping out, achieving better clinical outcomes means providers can participate in pay-for-performance and quality reporting initiatives.

Health IT and EHRs are not a panacea to physicians' economic woes, but they can help. It surely won't be easy, but the cost equation is now favoring EHRs.