From the July/August issue of Government Health IT.

In both technology and healthcare, groundbreaking ideas are frequently ahead of their time. Remember Apple's Newton?

That cutting-edge tablet device preceded the iPad and its brethren by approximately 20 years then fizzled out by the late '90s and was effectively forgotten; just not in Cupertino.

Existing technology, wondrous though it may have been, simply was not enough to fulfill Newton's mystic-like idea, particularly not functionally and cost-effectively enough for it to storm into consumer hands, let alone businesses and healthcare entities, nearly as successfully as the iPad has.

Technology and price were not the only reasons the Newton was no iPad, of course. One could argue, and rather easily, that people just weren't ready for such a device in the late 80's and 90's.

The same might be said for value-based purchasing (VBP), as it appears that some people and some technologies may not be quite ready. Taken with meaningful use and accountable care organization (ACO) measures, the "whole concept of having to collect information to be turned into quality reporting is like a tsunami coming our way right now," Deane Morrison, CIO, Concord Hospital told John Morrissey for this issue's cover story, VBP: Can you get there on today's IT?

Electronic health records and the data they house will be critical components of the future VBP model, just as they will form the foundation of statewide HIEs that feed into the grand vision of a Nationwide Healthcare Information Network (NwHIN). Readiness questions pervade there, too, and as Jeff Rowe found while reporting on Mapping the future of NwHIN, the continuously-changing technological trailways of health data exchange are pushing the limits of how financially viable the HIEs, let alone NwHIN, can be in the near-term.

NwHIN is a path that we as a nation have not traveled before. But the DoD and VA have been down the joint EHR road, a decade ago, at a time that just wasn't right culturally or technologically. Today, technology is the easy part, though it's not entirely clear if the time is right for the other pieces, namely fostering an open source community and alluring outside providers to ratchet up the project into a virtual lifetime electronic record (VLER). "The technology exists, we know it works, so it's a matter of creating that community and keeping it moving forward so it can sustain itself," said John Scott, author of the paper Open Technology Development for Military Software. 

In the here-and-now, meanwhile, there's no doubt that plenty of people are ready for the freshest wave of tablet devices. Healthcare agencies are starting to see various tablets come in their doors, carried by employees. Some health agencies are already welcoming and sanctioning the devices, others are testing, and many are still wondering what to do when employees practice BYOT (Bring Your Own Tablet), as Bob Violino saw in Invited or not, tablets are coming to your workplace.

And the iPad, not the Newton, is among those tablets users are carrying from their homes and into your IT domains – because this time, the time is right.