It ran through my mind about six years ago when this whole thing about RHIOs , EMR and Health Information Exchange began.
There were multiple attempts at forming business entities which were sustainable. Millions of dollars were spent setting up 'pilot programs'. Attempts were made to reinvent the wheel. There was more time and money expended setting up committees, seeking stakeholders and the like. Redundant non profit entities were required to access precious grant money to start some of these entities. Most failed miserably.
Even now in California there are multiple entities circling the wagons around each other. (CAEC, eHealth, CALIPSO) I sit in on many of these meetings via webinars. There are a lot of well meaning advocates , and 'techies' in these calls.
An intense feeding frenzy has developed around ARRA, HITECH and other governmental eponyms. Government has become a four or five-letter word.
Any fool should have been able to figure out reinventing a network was not necessary. We already had a great network, call it Verizon, Comcast, AT&T or whatever. Plug in your EMR and off you go. The key was and is software. These networks are already technically capable of providing HIPAA security as needed.
The key is interoperability and that has been established by CCHIT certification. It's been around for four years. Of course now the federal government wants to usurp their developmental success and supplant it with an "equal opportunity" organization that is appproved by some governmental regulatory agency, like the NIST.
The reward for all the hard work of EMR vendors, and voluntary industry people is cancelled out by the 'do-gooders' in D.C.
Negative reward is always the fallout from governmental -come- lately- to the table, initiatives. They sap entrepenurial initiative, investment and commitment to success rather than 1000 page documents written by the government.
So what happens now to the 40 or more vendors who have CCHIT certification, and the thousands of medical practices already invested in these ' legacy systems"? Undoubtedly they will be grandfathered in in order to satisfy medicare requirements for meaningful use to meet the governments (read medicare) requirements for incentive payments. 44,000 dollars is not a great incentive, nor adequate for someone to discard a system that perhaps cost 100,000 dollars last year or the year before.
Well, back to my comments on the 'original network(s) Verizon,Comcast, or Charter.MedVirginia and Verizon have already partnered using the NHIN to link with Social Security for processing Disability Claims and medical records
Actually when one thinks about their 'offering' HIE, and/or Regional networks become superfluous and redundant.
Any practice EMR can 'plug in their cord and 'dial up" anywhere Verizon or a like system is in place.
Keep it Simple, Stupid !!!! K.I.S.S.
As for me I am buying VZW . I thought of this five years ago, where is my cut?