For providers considering a commercially available system installed as a package, only a limited body of literature is available to inform decision making. The available evidence comes mainly from time-series or pre–post studies, derives from a staff-model managed care organization or academic health centers, and concerns a limited number of process measures. These data, in general, support the findings of studies from the benchmark institutions on the effect of health information technology in reducing utilization and medication errors. However, they do not support the findings of increased adherence to protocol-based care. Published evidence of the information needed to make informed decisions about acquiring and implementing health information technology in community settings is nearly nonexistent. For example, potentially important evidence related to initial capital costs, effect on provider productivity, resources required for staff training (such as time and skills), and workflow redesign is difficult to locate in the peer-reviewed literature. Also lacking are key data on financial context, such as degree of capitation, which has been suggested by a model to be an important factor in defining the business case for electronic health record use (97).