Financial incentives to implement EHRs may finally nudge some paper-based hospitals and practices into the 21st century. But given the HITECH Act's short implementation timeline, those facilities that aren't even close to getting out of the paper game may be left in the dust. Too bad for them, I say.

Let's just hope, for patients' sake, the people working at those facilities that go from all-paper to EHR are willing to make a huge change in their daily processes. If not, the short timeline may do significant harm to critical operations such as coordination of care and staff communication.

It seems there's much worry over this "zero to 60" implementation approach that HITECH is potentially encouraging -- and yet 2011 is still bearing down on providers as the "do or die" date for getting live and "meaningful."

If providers go from all-paper to fully meaningful EHR/CPOE in the next 1-2 years, they could theoretically receive incentives and practice medicine with the help of modern IT and everyone, including all patients, could benefit. But if for some (entirely likely) reason there is a lengthy adoption curve, unforeseen associated costs, and even a de-installation as a result of a classic "garbage in, garbage out" scenario, everyone, including all patients, could suffer.

This all begs the question: Do those providers whom are still fully entrenched in antiquated, paper-based processes even deserve stimulus funds?

I don't think it makes sense for any hospital or clinic to be paper-based in 2009. Surely even the most cash-strapped facility should have foreseen the transition from paper to electronic records -- it's only been about 50 years in the making at this point -- and mapped out an approach to using some form of EHR.  I'm aware of the controversial necessity of incentive-worthy systems to be CCHIT-certified, but that small hospital with the no-name, uncertified EHR is in far better shape to jump on the HITECH train before 2011, simply because their staff have already ingrained EHR into their daily routines. 

Blumenthal, HHS and Obama had to set some sort of deadline for HITECH (preferably within Barack's first term, I presume). For providers whom have made the first steps in the transition to electronic records, 2011 may not be too soon after all.

It's the institutions that have lacked any EHR plan that run the largest risk of fumbling the fast transition, and that's why they shouldn't even try to do it by 2011.  From what I've been told by countless CIOs, doctors and analysts, it's just not enough time for those fully paper-based folks.