The question that concerns me about the latter is what happens when the funding goes away. I've seen this occur already in some funded "meaningful use hopeful" standards projects (projects hoping to get a line a in the reg at some point). The interesting thing is what happens when the funding disappears. Momentum gets lost, sometimes enough that the standard itself might never really get finished, or implemented, or used.
Look at Direct for example. it is certainly suffering from the lost momentum problem. Was it worth it? Given that Direct got the MU mention it was after, it will probably succeed. But is the artificial stimulus the best approach? Maybe, but maybe not. I don't know what other levers to pull, but I'm surely looking for them.
This is exactly the problem epSOS now faces. This month enters its final pilot phase, and the funding source is uncertain yet. Please take a look at my "Architecture Issues For eHealth Interoperability" article http://bit.ly/1lYGQqd which provides an overview of epSOS and ends up with this kind of pondering
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