One thing learned early in the career of every medical innovator is that if your new idea requires major ergonomic or situational changes in the delivery system to work, its adoption will  be slow, piece-meal and likely insufficient to make a significant difference in the system.  As this article points out, this is not a technology problem but a system innovation problem.  There needs to be not only incentives, but real support and some degree of uniform software applications so that interoperability is maximized.  It has been our observation that by and large, the government does a poor job at this type of thing.  Time will tell, but Federal dollars would be best spent supporting the initiative without becoming the defacto supplier of EMR solutions themselves.  The marketplace has a wide array of sophisticated choices available, we just need the correct market incentives to get this going . . . jomaxx©

Small physicians’ practices may have difficulty implementing EHRs, experts say.

In its economic recovery package, the Obama administration plans to spend $19 billion to accelerate the use of computerized medical records in doctors’ offices. And, according to some medical experts, “electronic patient records, when used wisely, can help curb costs and improve care. But, 3/4 ths of the nation’s doctors practice in small offices such an investment…looks like a cost for which they are not reimbursed. Obama’s legislation would provide incentive payments of more than $40,000 spread over a few years for a physician who buys and uses electronic health records (EHRs). These payments, however, would only go towards the ‘meaningful use’ of digital records, and the government has not yet defined that term precisely.  The legislation also calls for creation of ‘regional health IT extension centers, which some experts say may serve as a crucial bridge to success by helping physicians in small offices adopt and use electronic records. . .

It is scarcely surprising, then, that only about 17 percent of the nation’s physicians are using computerized patient records, according to a government-sponsored survey published last year in The New England Journal of Medicine. So the legislation states that physicians will be paid only for the “meaningful use” of digital records. The government has not yet defined that term precisely. While the long-term goal is better health for patients, that can take years to measure. Consequently, many health experts predict that the meaningful use will be a requirement to collect and report measurements that can be closely correlated with improved health. Examples would be data for blood glucose, cholesterol and blood pressure levels for diabetes patients . . . . . read article @ http://www.nytimes.com/2009/03/01/business/01unbox.html?_r=1&ref=health