Abstract
It is very obvious that the government has stepped up to the plate to start what could be a very successful venture. But, at this point continued intervention is needed. It is recognized that there are still technical issues related to functionality and interoperability. The problems appear to be due to sociological, cultural, and financial problems. But, in the end most would agree that the issues are related to managerial more than technological problems. Experience and research implemented by those with failures have identified the most important concerns being,” what constitutes success and what is failure?” Their question is what contributes to making successful or unsuccessful systems? How do these companies use their system failures to enhance learning opportunities for continued company improvement? How should they study this success or failure? The determination was related at workshops directed by the AMIA to enhance opportunities for future successes, with a research agenda and recommendations. The AMIA was convicted to take a leadership role and come up with practical projects that would likely succeed in a health care setting.

Introduction
In February 2009 Congress appropriated $20 billion for health information technology as a part of the President’s stimulus package. Then the United State joined with other countries to benefit from healthcare technology. Because of the changes made to Medicare and private insurance plans, new paradigm for payments have been made to reflect Value-Based Purchasing (VBP), or pay for performance initiatives (P4P). These initiatives rely on electronic health records to document clinical services. There is growing concerns about how that technology is ultimately designed and deployed. The United States National Research Council advised that nationwide deployment of