Comment on FR Doc # 2012-11775

1. Requirements for electronically sending referrals to specialists cannot be considered until the specialists are required to receive referrals electronically. Most specialists are not PCMH's and many don't have electronic systems. 2. I practice in an area with a large rural retiree population, many of whom do not use computers. Therefore, meeting goals of electronic patient communication will be very challenging. This should be measured not on % of patient population but on a pass/fail basis of whether or not an organization is using it at all and has the capability of doing so.