Richland Medical Center, an independent 26-provider group practice with three sites in rural southwest Wisconsin, has used a legacy electronic health record for more than 20 years, but in the age of value-based accountable care and the desire to become a patient-centered medical home, a major upgrade in technology was in order.

At the time it bought the original EHR the vendor had not yet fully developed the practice management system so most administrative functions were done manually and it pretty much stayed that way until now, says Brian Puls, assistant administrator of finance. But with pay-for-performance a growing mandate among insurers and serving a population of 30,000, Richland now needs modern technology to capture the data.

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