I read a very interesting and well-written post on the Healthcare Blog by MARGALIT GUR-ARIE.

http://www.thehealthcareblog.com/the_health_care_blog/2009/09/what-if-i-had-to-do-hit-all-over-again-.html

It reminds me of the conversation in the movie City Slickers when Billy Crystal tells his friend his life is a do-over. From where I sit, I think a do-over is exactly what’s needed on two fronts. On the provider side, EHR decisions need to be based on what business problems are being addressed and on an ROI, not on what DC may or may not do. On the interoperability or transport side of the record I do not believe much of what is being worked on today will exist in 3-5 years (which further compounds the difficulty of what the providers are doing.) I think Meaningful Use and Certification will cease to exist, and that the structure of hundreds of Rhios and HIEs will cease to exist because they will have failed to work.