Much of the national EHR activity is centered at the Office of the National Coordinator for Health Information Technology, currently led by David Blumenthal, M.D. The various entities overseen by this office focus on different aspects required to define and encourage adoption of EHRs, including policy, technical standards, and certification that EHRs meet certain functional criteria. Starting in 2011, physicians who treat Medicare or Medicaid patients will be eligible for incentives of up to $44,000 over 5 years if they can demonstrate "meaningful use" of EHRs, and clinicians who are not using EHRs by 2015 will be subject to financial penalties. While the requirements of "meaningful use" had not yet been finalized by the Department of Health and Human Services when this was written, a proposed rule was issued in December 2009 and includes features intended to improve quality and safety (e.g., drug-drug interaction checking, incorporating laboratory results into the EHR, integrated performance measures), increase patient and family access to their clinical information, improve exchange of information among clinicians and thus care coordination, make certain data accessible to public health agencies, and protect privacy and security (1). These criteria will evolve over time as new EHR products and capabilities emerge.