Remember, the HITECH act (aka Meaningful Use) is a an incentive program, not a mandate. As we look at stage 2 we will be evaluating the increasing effort against against the decreasing financial incentive – remember stage 2 is worth less than half than stage 1.

Sure there is a supposed penalty, and we will need to take that into account too. But that penalty, starting in 2015 (or later), will be based on the amount of Medicare increase. Medicare may not be increasing by 2015.

Before I pitch a multi-million dollar effort to the senior management team we have to evaluate the ROI.

The other consideration is how much of the Stage 2 objectives are in synch with our patient care executives vision for clinical IT.