I really want to believe in ONCHIT's and CCHIT's efforts. When the first round of certified systems was announced a week or so ago, I looked at the CCHIT documents, especially those arising from the process leading to the certification benchmarks, and they have been very thorough. This is a tremendously difficult technical challenge and their efforts are a laudable first step. However, as I wrote at that time, the real challenges are not technical, but political at the macro and micro levels, in fact at every level.
Shahid Shah posted a very informative entry about a CCHIT dog and pony show he attended, with links to yet more detailed information. It is well worth your time.
At a recent AAFP meeting, Secretary Leavitt made clear, albeit only when pressed, that those who pay for an interoperable system will not be those who benefit from it, in large measure. Family practitioners and community clinics throughout the US, and their numbers are legion, often cannot afford to upgrade their software, let alone upgrading for someone else's benefit.
From another angle, one can ask: why should ONCHIT/CCHIT be any different? Disparities of work and benefit are rife within our healthcare system on the provider and payer fronts, while disparities of need and access abound on the consumer side of the table. To make a clinical analogy, the ONCHIT/CCHIT efforts are aspects of an attempt to put a Band-Aid on an annoying contusion while ignoring the third-degree burn over 15% of the patient's body - the patient in this case being our nation, the burn being the 45+ million uninsured (http://www.cbpp.org/8-30-05health.htm). We get healthcare that is mediocre at best (http://www.rand.org/pubs/research_briefs/RB9053-2/index1.html), and yet pay almost two and a half times the average for industrialized nations (http://www.cmwf.org/publications/publications_show.htm?doc_id=221624).