The federal government might be the party in the best position to get modern information technology into doctors’ offices.

Analysts at the Congressional Budget Office, write about that possibility in a review of evidence on the costs and benefits of health information technology.

Many believe that the U.S. health system would be more efficient of doctors and other providers depended more on electronic health records and less on paper charts, the analysts write in the paper.

But few physicians have the technical skills or enthusiasm to set up the systems today, converting paper medical offices to EHR systems is time-consuming and expensive, and doctors might have a difficult time making the systems pay for themselves in a reasonable period of time, the analysts write.

Although health insurers might have an incentive to help providers acquire health IT systems, “the same savings and improvements in quality that such a payer might reap if providers used a health IT system could also benefit competing health insurance plans,” the analysts write.

Some health insurers are trying to encourage use of health record systems administered by their own organizations or by independent organizations, rather than by health care providers, but many carriers and providers are reluctant to participate in open or multi-organization health record systems, the analysts write.

The federal government might have a natural role in helping to pay for the introduction of health IT because the federal government, as a major buyer of medical services, would benefit greatly from increased efficiency, and health IT may be a “public good” – “a good that would be provided in a less-than-optimal amount by private markets if the government did not intervene,” the analysts write.

One challenge to private vendors, the analysts write, is that many users of health IT may be able to become “free riders” and use the systems without actually paying for them.