Cambridge, Massachusetts-based Chilmark Research is keeping a sharp eye on HITECH requirements. "Unfortunately, you can't just throw money at IT and expect to miraculously create something vibrant and viable. It's difficult, and they're asking quite a bit to be done in a very short timeframe," stressed Chilmark's managing partner, John Moore. "I don't think it really takes into account the challenges that clinicians will face and that management will face in regards to adoption, and to how they map workflow to not make it disruptive but contribute to the process of care."

Moore lists several high-profile institutions, including the Cleveland Clinic, Kaiser Permanente, and Boston's Beth Israel Deaconess as highly sophisticated early-adopters who are faced with meeting HITECH provisions. "These organizations are operating very savvy IT staff and even they are challenged to meet [those provisions]. When you start looking at some of your smaller clinics and rural hospitals that may serve a very large Medicare and Medicaid population, they are going to be extremely challenged."


The AHA's May agrees. "Hospitals with less than 100 beds have tremendous difficulty accessing the capital needed to invest in these IT systems, but it's more than that. It's having a fully functioning IT staff that can implement these systems and manage them. It's being able to train all the staff at the hospital, train the physicians and the community doctors. There's a lot that goes into it, not just the upfront costs but the ongoing costs that are beyond where many hospitals are today. That's one of our biggest concerns about the way this bar is set."

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