Even as the Office of the National Coordinator named Cincinnati and Detroit as its final two of 17 Beacon Communities on Sept. 2, it was already at work on measures designed to share what IT approaches work best for the Beacons with clinics and medical practices across the country.

The methods for sharing include revised Web site where the 17 Beacon grant winners, as well as newly chartered health IT regional extension centers and state-sponsored health information exchanges can share their experiences.

ONC is also in discussions with the Robert Woods Johnson Foundation to increase the number of health IT-related communities-of-practice, collaborations of the kind that will be set up by the Health IT Research Center, a national clearinghouse of research and lessons from those taking first steps at going digital.

ONC's aim is to compile and make available a collection of real-world best practices, Blumenthal said.

"Although our resources may be pretty much exhausted, there may be private resources of support that can create communities of practice to learn from one another (and) move forward with using information technology to actually improve care," he said.

Blumenthal emphasized the coordination being fostered throughout ONC grant programs.

In the Buffalo-Western New York area, for example, the Beacon community has a close relationship with the local extension center, he said. The REC in turn is working with the Beacon to bring in physicians that support them in meeting their health outcome goals.

"I think this is going to be a kind of foxhole by foxhole, physician by physician, hospital by hospital activity, where once a community is organized around a set of goals, you can expect that the regional extension center will be participating in support of those goals," Blumenthal said.

Often the state agency for health information exchange is also part of Beacon activity, such as in Utah, he added.

"We are weaving these activities together in the greatest possible extent, Blumenthal said. "We are also holding regional meetings where we bring the Beacon communities, regional extension center and state HIE personnel together to collaborate."

Where extension centers and Beacon communities are organizationally related, it makes it simpler, he said.

The Beacon communities will be bellwethers for the next stages of meaningful use, Blumenthal said. "We will be looking at the Beacons for what's possible to expect in future stages."

That's because most Beacon communities are already well ahead of the adoption curve, with many at 50 percent to 60 percent health IT use among local physicians. Blumenthal said 130 communities competed for Beacon grants in the first round of the program.

"There are lots of communities focusing on health IT right now, and there are many others that didn't get beacon grants that also we think will move forward at a rapid pace toward meaningful use."

As to whether he will still be at the helm of ONC to shepherd the meaningful use program through its first stage, Blumenthal said he was "having a great time" and had "no plans to change what I am doing."