If you think this whole "meaningful use" thing is a challenge, just wait 'til you hear what they're trying to do over in Europe.

Last week, the European Commission--think of it as the executive branch of the European Union--published its "Digital Agenda," a 10-year plan for IT advancement across the continent. Healthcare figures prominently in the agenda, including the goal of providing secure, online, patient-controlled medical records for many Europeans in the second half of this decade. There are some interim steps in the near term, though.

One aim, according to E-Health Europe, is to "increase safety and medical assistance to Europeans, for instance in an emergency abroad, by defining a minimum set of health information to be included on patient records that can be accessed electronically anywhere in the EU." This is to be done by 2012.

Let me repeat that: European leaders expect to have basic medical histories available to much of their populace across 27 countries within two years.

It sounds like a heady task, particularly since there are no fewer than 23 official languages in the EU. (Think about how elusive semantic interoperabilty is in the U.S. with mostly English involved.) But the standards for exchange of a minimum set of health data already exist, in the forms of the Continuity of Care Record and Continuity of Care Document, and they've already been accepted in many EU countries.

This goal actually sounds more achievable than, say, providing interoperable EMRs to 300 million Americans by 2014, since it's biting off a small piece rather than taking a big bite. That's kind of what another huge bureaucracy, the U.S. Department of Veterans Affairs, had in mind when it started its innovation initiative, asking employees to come up with ideas on how the Veterans Health Administration could improve care and save money.

Just before the long weekend, the VA announced the winners of its second such competition. Things like adding patient photos, search functions and support for touch-screen technology sound easily achievable. Simple enhancements can go a long way, even as part of a grand plan. Think about that as you aim for meaningful use. - Neil