WTF ppl? I did a Find on this thread and discovered one mention of the most ubiquitous EMR of all time... CPRS. It's the most successful and completely invisible health care tools in history, apparently. It was started back in the 80's and has been a graphic record-keeping tool since the early 90's. Why would anyone want to credit the government for anything well-done, after all?
CPRS is secure, is used in major hospitals, dental offices, small corner store community centers (scales easily), is free, open-source and easily configurable. The technical support for CPRS can be done by most plain vanilla tech support shops, the clinical interface is easily learned and well-loved by clinicians and it allows a tone of other products to "hook" into it.
CPRS does not give access to insurers for the most part inhibits profiling. An Information Security Officer can patrol the access and use fairly effectively.
The next version of CPRS will be platform-independent and built so that users can access lab and other information, request refills, etc. CPRS is going to be ported to the web soon and has been demo'd on the Apple iPhone, Linux and Apple computers (aka, it's not a Windows only solution).
Yes, it's got some rough edges and problems, but it has been on the job for nearly 2 decades...
So, back to the article that was referenced... the implementation of CPRS and BCMA has proved that an EMR can be launched successfully and effectively. The tech support for CPRS was drawn from the ranks of the VAMC nursing and lab staff, none of whom (to a woman and man, as far as I'm aware) had computer applications training or degrees. A lot of the developer support has been contracted and it has worked very well. There have been a few blowouts, but CPRS is largely loved by all.
The corps of very experienced trainers/developers/software specialists can be easily tapped at this point... many of the original CPRS implementation staff are now retiring and are looking for private sector employment. It's been almost 20 or more years and the experience of the VA shows that the transition CAN BE DONE... enough whining and let's get going!
The amount of money to be saved is a boat load and more. And the jobs created for support staff will replace all the clerical jobs lost.
I've been a clinical applications coordinator since 2003 so I should know... I did not have a day of computer training prior to starting the job. I was handed a key as my only mentoring experience... I am a nurse, and if I can do it, anyone can do it. And there are LOTS of nurses and clinicians who would jump at the chance to do something this thrilling.