Can one of the technologies most associated with the fee-for-service era the EHR reinvent itself for the very different requirements of value-based care? We regularly convene leaders from specialty practices nationwide to discuss their value-based care progress and recently posed this question to an audience representing more than 530 oncologists. More than two-thirds of respondents either said that their EHR was not ready, or they did not know whether it was ready, to accommodate alternative payment models, bundles, or other innovative payment methodologies.The physicians response is not surprising when one considers that EHRs were built to automate a fee-for-service world. These applications specialize in documenting patient encounters in office settings and converting those interactions into billing codes. As a result, practices are finding that they often fall short in supporting key requirements of the Merit-based Incentive Payment System andor alternative payment models. Practices report key challenges including the following:

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