Meaningful use of information technology: a local perspective.

To reduce costs of care and improve quality, the federal government is stimulating adoption of health information technology through meaningful use policy. The legislation, however, is built on several assumptions that are unrealistic from a provider's perspective-the group that is expected to purchase, use, and sustain the information technology infrastructure. A viable meaningful use policy may do better to account for the realities of patient care by using a bottom-up approach for adoption rather than the current top-down strategy.