A tale of two large community electronic health record extension projects.

The Massachusetts eHealth Collaborative and the New York City Primary Care Information Project have provided financial subsidies and extensive support to help hundreds of independent medical practices successfully adopt electronic health records. Their efforts address overcoming key barriers such as the amount of start-up funds needed, productivity lost during implementation, and the difficulty of choosing the right system. Their approaches differ: the Massachusetts project emphasizes continuity of care within selected communities; New York emphasizes improvements in preventive care and chronic disease management across a population. Both, however, offer valuable insights that can be applied elsewhere.