Here’s a response I wrote for a very interesting conversation started by Andy Oram, though a posting, http://radar.oreilly.com/2009/11/converting-to-electronic-healt.html

I think the very existence of the Regional Extension Centers (RECS)is but another sign that there is no workable plan for a national rollout of EHR. There is a plan, a word I use reluctantly—there may be several. Several things surrounding the rollout exist that reinforce the idea that the plan is not operational—Meaningful Use, Certification, RECs—and these things exist as a series of band-aids in the hope they will enable the plan. These band-aids have been cobbled together over time and by different parties.
There is no EHR Czar.

There is no roll out czar. I defy anyone to present their work plan for how this ties together and show where these add-ons are on the plan.

Back to RECs. Similar format to Healthcare Information Exchanges (HIEs). Political in their origin and format. Carte blanche in terms of how they are built, what they will deliver, how they relate to HIEs and standards, and how the quality of their output will be measured. Five hundred and ninety-eight hope this helps million dollars. Has anyone sought out the credentials of those running the hope-this-works RECs? Does anyone doubt that they don’t have the experience to make these of any value? Where’s the national REC work plan? The individual work plans?

Who likes the REC idea? The payors. Regionally deployed and state authorized, the payors have more than a vested interest in helping the healthcare providers in their region with their EHR efforts.

This is another lipstick on the pig effort. By now, the pig is just about covered with lipstick. Does it make it a better pig? Of course not, it just makes it red.