IntroductionThis case study will show how a facility can stimulate or encourage the adoption of electronic health records through pay-for-performance, and will demonstrate the financial and human resources involved in implementing an electronic health record in a small medical practice versus a large-scale healthcare system. We will also look at identifying the various challenges facing small practices in implementing an electronic health record. As well as focusing on the differences compared to the effects of a large healthcare system. Pay-for-Performance Payment for performance (P4P) was created as a way to link provider and Medicare together to measure performance based on payment. As a spokesperson for the employer coalition stated: “We believe that this approach to physician compensation will improve the quality of health care patients receive and ultimately reduce the overall costs of care (Christianson 2006). The incentive is to get the provider to focus on the patient by providing quality care. The Dryden Family Medicine (DFM) center achieved its immunization goal of 95% in the allotted time. Achieving this criterion at such a fast pace placed them in first place and earned them a nice bonus package. As stated by the New York Times “P4P had no visible effects on processes of care or on clinical or hypertension-related outcomes.” As for hypertension or other types of chronic diseases, P4P had no results. A stimulus package was created to encourage doctors to switch to EMRs by 2015. The total allowed by the federal government was $19 billion. It will be up to the doctor or facility to decide which EMR program best suits their... middle of paper ......orks CitedAbelson,R. (January 26, 2011), Financial Rewards for a Doctor's Care http://prescriptions. blogs.nytimes.com/2011/01/26/financial-rewards-for-a-doctors-care/?_php=true&_type=blogs&partner=rss&emc=rss&_r=0AHRQ, (October 2011), Study Identifies Costs of Implementing electronic health records in medical practice networks, http://www.ahrq.gov/news/newsletters/research-activity/oct11/1011RA15.htmlChristianson, JB, Knutson, DJ, Mazze, RS, (February 21, 2006) GE, Ford, UPS, P&G, Verizon and others support a new payment-for-quality initiative for doctors. NCQA News.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2557129/Miller RH, Sim I., (2014) Physician Use of Electronic Health Records: Barriers and Solutions, http:/ /content .healthaffairs.org/content/23/2/116.fullTan, J., Payton, F.C., (2010), Adaptive Health Management Information Systems 3rd Edition