I don't believe anyone in the healthcare industry believes ARRA will single-handedly drive up EHR adoption among providers. Of course, the hope is that the federal incentive money will bring physicians, for whom cost is an issue, into the fold. But what's going to really move the needle on EHR adoption?

The answer is simple, but it's a multi-pronged approach: Agencies and organizations that receive data from physicians for their various programs such as quality and pay-for-performance initiatives should require the data to be aggregated, documented and sent electronically. They should also encourage EHR vendors to make it easy for physicians to collect whatever existing or new data is required.

A recent example is a new policy being instituted by the National Institutes of Health. NIH is requiring its physicians to document radiation levels of their patients who are exposed via CT scans or other imaging procedures. Vendors that provide their imaging equipment to NIH must provide software that documents radiation levels and transmits that information to the patient's EHR. The thought is to have Google Health and Microsoft HealthVault enable access to the radiation data, which would be replaced later by a national EHR system.

Other organizations should follow suit. With the Centers for Medicare & Medicaid Services leading the way on the payer side, commercial payers that have or are planning to implement patient-centered medical homes or pay-for-performance programs should require data capture and reporting to be done via EHRs. For PCMHs, EHRs would also help enable continuity of care, but that's another topic entirely.

EHR vendors can help their cause by aligning their products' capabilities with what the market is requiring, outside of the meaningful use criteria.

The federal or state governments need not be the only ones drawing up policies to drive EHR adoption. If a good number of a provider's business partners require the use of an EHR, the EHR system becomes an invaluable office equipment and tool. And that is a pretty good business case.