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I must admit, I was surprised when I read that Massachusetts's healthcare law, passed last summer, includes a provision that requires physicians to demonstrate a "proficiency" in the use of EHRs, electronic prescribing, computerized physician order entry and other forms of health IT as a condition of licensure. This law goes far beyond the federal HITECH Act and Meaningful Use program. HITECH will impose financial penalties on physicians who don't meaningfully use electronic health records by 2015. In Massachusetts, physicians who don't meaningful use their EHRs by then will lose their licenses to practice their livelihood. 

That's a big difference.

True to its word, the Office of the National Coordinator for Health IT is moving at full steam to provide governance support to health information organizations (HIOs) to spur the industry to widespread electronic data exchange. ONC has formed a governance framework with business, trust and other principles to create a "common foundation" for all types of health information exchange governance models. Still, I wonder if this decision ultimately may come back to haunt the industry.

I read with dismay last week's article by well known Washington Post business columnist Michelle Singletary, who questioned whether several hospital employees should have been fired by a hospital in New Zealand for inappropriately accessing the hospital's electronic health record to view the information of a patient with a "titillating" medical emergency, and then sharing the records with the public and media.

The Boston hospitals that have been treating the hundreds of victims of the horrific Boston marathon bombings this week have done a terrific job. They, in turn, have credited technology in helping them communicate to staff, volunteers and the public. I presume that these hospitals also have good electronic health record systems that they can rely on. But I can't help but wonder: wouldn't their work have been enhanced even further and their jobs made easier if the nation was further along in health IT and interoperability?