DENVER – For Catholic Health Initiatives, a Denver-based health system with 55 acute care hospitals across the country and no electronic health record system, the challenge of achieving meaningful use will be "keeping the wheels on the wagon, so to speak," says Evon Holladay, vice president, business intelligence.

Holloday was part of a panel of hospital executives, vendors and government officials who spoke about meaningful use Tuesday at the iHT2 Summer Health IT Summit in Denver. The focus? "Where do we go from here?"

The answer was different for each organization and ran the gamut from Catholic Health Initiatives (CHI), which is starting from scratch with its $1.5 billion rollout that will include technology from Cerner, Meditech and Allscripts, to health systems that need to fill in the gaps.

"I think it's going to be a bumpy road, but not crater filled," said Andrew Steele, MD, director of medical informatics at Denver Health.

Denver Health has spent $400 million for healthcare IT over the last 10 years, said Steele, so it's not starting from scratch. Yet there will be challenges.

"We have to have laser focus on meaningful use, Steele said. "That's going to be a sell job. We need to figure out what are the gains and how to explain it to them."

"They" are the clinicians that use the electronic records. The explanation will be less about technology and more about leveraging our "quality initiatives," Steele said.

Dana Moore understands that emphasis. Moore is senior vice president and CIO of Centura Health, billed as Colorado's largest health system. It is a $2 billion operation with a Meditech system in place. Moore says meaningful use is a roadmap Centura has already pursued.

But some clinicians have questioned Centura's motives in re-examining and filling in the gaps to meet meaningful use objectives.

"Skeptics in the crowd are saying, 'you're doing it to get the money,'" he said.

That meaningful use incentive money, Moore said, "must be re-invested in quality projects.

Mark Levine, MD, chief medical information officer for the Centers for Medicare and Medicaid's Denver region, would see that as a fitting investment.

"The goal, of course, is the patient."

As the nation transforms the healthcare system into an electronic one, he said, it has to keep the patient front and center, and it has to include everybody – critical access hospitals and small physician practices as well the integrated delivery systems and academic medical centers.

"Otherwise, we are going to worsen the situation," he said.