They may not hold "buy one, get one free" sales, but like any other business, hospitals compete for customers. Unlike other industries, health care lags in using IT for efficiency, never mind competitive advantage. For example, just 1.5 percent of hospitals in the United States use comprehensive electronic medical records, according to Kaiser's Fasano. "It's a manual, disconnected industry," he says.

Yet we know automation attracts customers. Sixty-two percent of 1,000 consumers polled by NCR said they are more likely to choose a hospital that lets them pay bills, fill out forms or schedule appointments online. Yes, NCR sells kiosks to medical organizations and no doubt cites those numbers during every sales call. But survey results show that people really want more technology in their healthcare interactions: Fifty-three percent want to book appointments via their mobile devices. Yet opening up a doctor's calendar to patients carrying iPhones isn't what Obama is talking about. That won't get you to the "meaningful use" of technology that the stimulus money requires.

So far, the federal group in charge of laying out the requirements has said that hospitals must use an EMR for jobs such as tracking medications, accessing lab test results and recording patient care progress. At doctors' offices, computerized physician order entry systems must replace paper notes, while at hospitals, at least 10 percent of doctors' orders must go through that kind of electronic system. Insurance claims must be from an office, clinic or hospital. IT definitely has the ear of C-level health care executives, says John Stanley, SVP and CIO of Riverside Health System in Newport News, Va. The question is how to bend it.

Riverside started automating physician-office-based patient records 13 years ago, but the stimulus incentives have "put some more urgency into our journey," Stanley says. He runs two different electronic medical records systems. The principal user is Riverside Medical Group, a multispecialty group of close to 400 practitioners scattered over multiple market areas. Many physicians currently utilize CPOE and electronic prescribing capabilities. They also have an electronic record system in their Acute Care division, and the two systems exchange information. CPOE is currently being implemented across the various hospitals, starting with the hospitalists.

These sorts of technology projects are winning out over other business projects to get capital and the OK to hire, he says, estimating that the hospital will receive $20 million, subject to final regulations, from 2011 to 2015-a goodly sum for a nonprofit.