Other than adding a wing to a hospital, properly implementing an Electronic Records System is undoubtedly the most complex, expensive, and far reaching undertaking with which you will be faced.

You have a “Pick me, pick me,” vendor mentalities—pay no attention to your requirements, they’ll only add to your confusion.

You have nobody making the rules; no decider—where’s George when you need him?

The targets are all fluid—don’t believe for a minute those selling meaningful use, certification, and interoperability.

There are a few hundred networks with their own standards hoping theirs will be the one chosen to drive the NHIN.

If you have more than one EHR at your facility—about half the hospitals do—by default you are building your own Rhio.

You have duplicate and dysfunctional workflows that are so far from best practices that it may not even be worth the effort to get to “best”—getting to a single practice may be more than sufficient.

And finally—let’s all take a collective sigh of relief—you are expected to transform an industry from version 0.2 to version 2.0.

So, what’s on tap for tomorrow?