For example, most health plans have a provider portal. Those infrastructures could potentially be leveraged to make the deployment of these tools easier and more effective. I also think we're going to look at [application service provider] models and strategies. Many of the EMRs have been constructed where application itself has been on site. That has to be hosted and supported and maintained by the group. I'm really just saying that should be done centrally and all the physicians' office has to have is Internet access.

Fasano: The country's [technology] challenges are larger than that initial $17 billion installment, and that's what I think it's going to turn out to be, an installment for electronic medical records and for making the entire healthcare industry electronic. ... I know what it took for [Kaiser Permanente] to implement our electronic medical record system [$5 billion over five years] and know what it costs us to support that on an ongoing basis [$100+ million annually] and it's a significant amount of money and commitment on the part of any organization like ours, and I suspect when you get down to smaller individual physician practices it will be a substantial cost and something that will need continued support from our government. I think it will require the paying model to be changed somewhat to help support that investment over time. There will consistently be need for maintenance.

Dare: It's important to note there are specific time frames in the bill. Those incentives are first available as early as 2011. What the bill does provide is timeframe certainties and especially in the case of physicians, specific numbers in terms of the dollars available to them in the incentive payments. If you're a physician, and you get your system up in place, you're eligible for a total of $44,000 in incentives over a four-year period. If you're a physician that practices in a professional shortage [rural areas] it is as much as $48,000.

If many of our health-care facilities don't have EHRs set up today, how will they have time to collect on the EHR-use incentives?

Dare: For hospitals, it's a larger undertaking than for a medical practice. It's not a long window of time for a hospital or health system that hasn't even begun thinking about doing this sort of system.