Summarize a summary a practice. On what is pay for performance how could it stimulate and encourage the EMR adoption what are the advantage and the limitation of the cost-benefit analyst for the it adoption or decision and if the practice has decided not to adopt the EMR what have been the cost of such decision what Milestones should achieve the term of it Readiness before a group practice decide to implanted EMR could there be an intensive and different set of channels for smaller practice to take an IMS project such as the EMR implementation then large-scale Health Service organization such as email multi provider Health maintenance organization if so what are the difference in terms of the incentives and why or why not.