Here’s a nicely written piece by Elyse of AntiClue. http://www.anticlue.net/archives/000970.htm
I look at the need from the perspective of the path not traveled. For most, the task of selecting the correct EHR and managing the effort would be like me buying a spaceship–never been there, never done that.
Providers are well-staffed on the clinical side, and on the IT side. The problem is that none of them has the high cost, high risk, high visibility PMO (project management officer) skills that are required to buy something that can cost more than a new hospital wing.
So what do they do? They pull someone out of IT or clinical and hand her the keys. Most large IT projects will fail. MOre EHR projects will fail.
That’s my opinion, but nobody has talked me out of it.
Pale Rhino Consulting 
You make a good point about the lack of project management experience that is prevalent in EMR implementations. Unfortunately that experience is best gained by working on projects and managers are reluctant to hire folks who haven’t been sanctioned by vendors, even if they have implementation extensive experience. It’s quite the paradox. The really wacky part is that the certifiaction process doesn’t address workflow issues, just technical specs.
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Thank you.
MY take is somewhat outside the mainstream. One camp wants the clinical side to run the show, the other is pulling for IT. I am pulling for neither, opting instead for a Program Management Officer (PMO) who knows how to lead.
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