2006 was a frustrating, perplexing, and promising year for EHR proponents and for physicians who considered making the leap into health information technology. The government continued its EHR push, and some employers and health plans began to incentivize doctors to adopt digital records. But the results of all these efforts were underwhelming. Not that progress hasn't been made. Even though only about 10 percent of doctors are now using advanced EHRs that can help them do care management, that's a big jump from several years ago. On the other hand, a high percentage of those physicians are in big groups, because physicians in small practices still tend to regard EHRs as too expensive and complicated. The government tried to bring down the cost by altering the Stark self-referral rules and adding an OIG safe harbor last summer. Those rule changes, in theory, allow hospitals to donate most of the cost of EHR software to community physicians. But, partly because of Congressional battles over a stillborn health IT bill and the IRS' reluctance to bless the rule changes, few hospitals have made overt moves to pay for physicians' EHRs. Meanwhile, some observers have noted that health IT donations might be used to bind doctors to particular health systems.