Honestly, knowing some funding is available fairly soon will help them progress. We would certainly say to hospitals, health providers and physicians, you would want to start now, planning and moving ahead in part because the incentive payments are bigger in the early years. If you wait until 2013 or 2014, whether you're a hospital or a physician practice, the amount of money available to you is less.

At the back end, it's a carrot-and-stick system. For those hospitals and physicians that don't adopt the EHRs, their Medicare reimbursement is reduced over time.

Kennedy: The funds don't start coming on line until 2011. I thought that was a reasonable compromise between the need to spend money today for economic reasons versus the need for organizations to get a project in place to begin deploying health information technology.

Secondly, I would define the problem more in terms of market segments. If you have the large integrated delivery systems or large groups, they already have much of the foundation in place. Even if they don't have full-fledged DMR [digital medical records], many have LANs in place. Many have provider authentication processes in place. So it's not like you're starting from scratch for many of these organizations. While I agree it's a challenge, I'm not sure given the restraints you can expect much else.

So should EHR information be shared regionally, statewide or nationwide, and how do you do that?