It's telling that a number of organizations-including the eHealth Initiative, the HIMSS Electronic Health Record Association, and provider alliance Premier Inc.-have issued calls for watering down or delaying the next stages of meaningful use criteria. They're concerned that too many providers will fall short as the MU bar gets raised higher and vendors won't be able to upgrade their systems in time for their clients to hit incentive deadlines.

But ... this is ignoring the reality that the incentive program was bound to create winners and losers. Some software on the market won't be able to deliver the functionality we truly need for interoperability; some care organizations are just not good at implementing or adopting I.T. But in both cases, a meaningful use program with fungible timelines, bent on making a winner out of everyone, is artificially propping up the laggards.

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