E-MDs' CCHIT-certified EHR, one of the more popular programs on the market, costs about $8,000 per doctor. While that's considerably less than the price of some comparable EHRs, it's still beyond the reach of many small practices, when combined with the cost of hardware, implementation and support. So e-MDs plans to release a "lite" version of its EHR early next year. This product will allow physicians to get into the game at a lower cost and upgrade to the full EHR later if they want.

Doctors will be able to use the web-based EHR lite for free for the first 100 patient visits, using digital "tokens" they receive when they sign up online. They'll have no further obligation, says neurologist Michael Stearns, chief medical officer of the Austin, TX-based vendor. But if they want to continue using the program, they'll have to buy more tokens, up to a maximum of $2,000 per physician.

The license this money buys will cover online support but not onsite training, unless a practice pays extra for it. Otherwise, the training will be done through videos posted on the web. But Stearns claims that the product will be so intuitive that most physicians won't need any training to start using it.

The e-MDs EHR lite will include everything a doctor needs to document an encounter or a procedure, he says. It will also have an E&M coder to assist in choosing the right billing codes, and it will be capable of interfacing with practice management systems other than e-MDs'.

As vendors like e-MDs and Spring start offering lower-priced versions of their full featured products, bigger companies are starting to eye the small-practice market, too. Misys Healthcare Systems, for example, just did a licensing deal with iMedica, which has an EHR designed for small offices. In November, Misys plans to launch several products based on iMedica that will bear the Misys brand, including a web-based EHR.

Paul Edge, vice president of product management for Misys, won't estimate how much the new EHR will cost. "Our product will be competitively priced," he says, and it will be appropriate for small offices that don't need all of the features in Misys' enterprise products.