In early 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act was adopted to promote the meaningful use of health information technology. Stage 1 of HITECH centered on 5 underlying health outcomes of meaningful use: (1) improve quality, safety, efficiency, and reduce health disparities; (2) engage patients and families in their healthcare; (3) improve care coordination; (4) improve population and public health; and (5) ensure adequate privacy and security protections for personal health information. While the passage of HITECH and application of new database technologies has prompted an increase in the use of electronic health records (EHR), the incentives of meaningful use has not been widely applied (Hsiao and Hing)3.