That's a tough one. I'll just take a few things I think we've learned from other countries.
The one thing that for sure seems to be driving rapid adoption is that you're somehow paying for quality. And then you need to ask, well, where are my diabetics? Have I actually done their annual foot check, ophthalmology check, their biannual glycosylated hemoglobin check? Where are they? And you need a computerized system to find them. Right now, you can't find them very readily without it.
The physicians we have in this fairly large prototype we run tell us, “Can you give me my list of diabetics? Can you give me my list of asthmatics?” So you need a computer to get the work done.
The second thing they did, and you could think of a kazillion creative ways to do this, is they put in place, either through the professional coalitions or through the government itself--so in Denmark, the professional coalitions, in the U.K., the government--deep investment to support the training and transformation of practice. So the computers, the network, the Internet and that kind of thing, paying for my staff to migrate to a new.... That's all on the providers' end. That's their business. They have to do that. So that isn't a solution that's going to work, for sure.
The third thing is this issue of value added. What problems are you trying to solve for me, the practitioner? What we realized is that they have fragmented information, so that's where our repositories will help. They actually want to have decision support, they want to have alerts on the 33,000 drug interactions that are available. They want to have that information. So there are some strategic value-adds, which I've added in my handout. If we build solutions along that line, in collaboration with the professional groups, I think we would be in better shape than we are now.