Just finished up with the first day of the HIMSS conference. A couple things of note. The HIMSS Conference is still huge and very up-to-the minute. You should be here if you are in this business. I'm also noticing more physician participation this year. Last year, it seemed there was a turning point in what I was seeing at the conference. It looked as though the applications and technology had come to the point where some of these "grand" ideas of EHR, EMR, general clinical paperless-ness were more possible in a mainstream-sense than they had been in the past. This year, it is possible we are seeing the effects of some real progress past that turning point over the past year. Seeing physicians co-presenting in several educational sessions, and even giving software demos on the floor, may reflect the fact that the technology is starting to work FOR organizations that have taken the plunge.. instead of us working for the technology. Nothing is changing in healthcare without physician leadership. I happen to like this idea, because I want my doctor in charge and accountable when I need care. As technology continues to improve things where the rubber meets the road, on the floor with the clinicians, then we will see greater adoption. So, get a IT governance structure in place, get physicians and other clinicians involved in the governance, set some clear goals and objectives and stand by those goals, and let people get creative to find solutions. Be a catalyst for change and manage it through.