ACO, ICD-10, MU, PCMH, and PQRS are more than just an acronym soup.

Sean McPhillips, project manager for the Kentucky Regional Extension Center, wants to know whether or not the government has any plans to coordinate these pressure-packed initiatives.

McPhillips said he's concerned that there isn't enough alignment in the various federal programs, forcing providers, who are primarily trying to focus on practicing medicine, to "jump through all these hoops for all these programs that seem to be competing with one another."

And it's what he asked of the new national coordinator Karen DeSalvo, MD, during a recent ONC summit in Washington, DC.

"I have seen the pain," DeSalvo answered.

Indeed, DeSalvo comes to ONC this month from the field as a practicing physician and former New Orleans Health Commissioner where she championed the cause of vulnerable populations.

"I completely understand. There are laws and rules and regs that are a necessity, yet we want to make this as convenient and realistic for everybody because we all have the same goals," DeSalvo added. "And there's been some internal thinking about it, along with CMS and others. As you all know the pain is coming from a lot of directions."

As the head of a regional extension center, McPhillips said he is on the front lines, listening to providers and trying to help them with EHR adoption and earning meaningful use incentives. So McPhillips, too, is aware first-hand of their frustration. He has also been working to make the REC sustainable after federal funding dries up because demand for its services goes beyond the scope of meaningful use.

RECs promise to be part of the solution to regulatory strain and stressors. Since June 1, 2010, the New Jersey Health Information Technology Extension Center has been building human networks and technology networks. RECs effectively have come to be "the face of ONC on the local level," said Bill O'Byrne, executive director of NJ-HITEC. "If we go away in the next year or so, there's going to be a desperate loss, and I'm deeply concerned about that."

That RECs such as NJ-HITEC have taken on the role is good news for providers, DeSalvo said, "because frankly that is what they're going to need. The complexity is there. What we want to make sure we do is not make it so complex that it interferes with patient safety or patient care or actually the joy of medicine, dare I say it."

DeSalvo said as a primary care provider from the ground in Louisiana she was part of these networks – both with a REC and the Beacon Community.

"I understand what it's like to be part of a network and how valuable that is for diffusion of knowledge and how powerful that can be for patient care," she said. "We are working on finding the best way to leverage and support in an ongoing fashion these potentially scalable relationships. Recognize you are valued."

Whether DeSalvo and ONC will be able to stir that stockpot of acronyms into a more easily digestible – if not altogether tasty – broth remains to be seen.

[See also: Karen DeSalvo: 10 facts you may not know]