by Joseph Ingemi

Now that HHS has finally defined "meaningful use," we all can expect a push for adoption.

Or can we?

With both the massive federal incentives and the potential for lower reimbursement rates for failure to adopt, will providers actually adopt Electronic Health Records?

Or will those who have already adopted EHR simply use this as an opportunity to upgrade?

I still have my doubts.

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Many providers may not know what incentives are available. Some do not know where to start. Some just will refuse to adopt.

I think that coordinators are needed to provide planning and implementation guidance to providers in unbiased way. These coordinators should be ready to offer regulatory, project management, technical and patient outreach assistance. This was the model when I worked as a project manager for Nationwide Health Information Network (NHIN) Phase 1. Business analysts were made available to coordinate and guide the activities of participating providers.

Are the EHR and the provider's processes compliant with meaningful use? What will be the total cost of ownership for the EHR? How do I monitor the implementation of the EHR? These are all questions the coordinator can answer.

So who should sponsor these coordinators? Providers won't want to pay for these services. Medicare and Medicaid are going through a lot of churn with healthcare reform and the stimulus. Plus, their sponsorship may lead to accusations of "government takeover" of healthcare.

The VA might be a good choice but they deal with a limited number of providers. Private insurers are not likely to sponsor these activities since the effort might assist other private insurers in the process. EHR vendors will be biased. The regional extension centers would be ideal but from what I have seen, provider participation might be an issue and there is the hazard of the RECs' becoming vendor clearinghouses.

So I see this leaves one choice: cable companies. Yes, you heard that right.

It's a natural fit. Cable companies or any telecommunication company offering non-wireless access would have a lot to gain from EHR. Health IT creates an increased demand for secure bandwidth. Thus, as more providers adopt EHR, the market for cable companies' services will grow.

Cable companies are payer and vendor neutral so the other stakeholders in the health IT market need not worry about one group gaining an unfair advantage. What's more, cable sponsorship of community coordinator activities ties together the administration's goal of coordinating broadband expansion and healthcare IT.

Ultimately, the adoption of health IT will require more than incentives. It will require guiding providers through the process. Cable companies have the potential to provide that type of leadership.

Joseph Ingemi is a blogger, Certified Information Systems Auditor, and certified Project Management Professional who writes about healthcare IT issues. He also consults on healthcare IT issues through his company, Pinarus Technologies.