Dr. Kibbe will describe the political and economic environment within which new models of patient-centered health care delivery, including the PCMH and ACO, are emerging. Alongside patient-centeredness, the "big idea" within these new frameworks is the assumption of both clinical and financial risk by providers and their organizations. Accountability for both quality and costs of care requires that providers choose health IT resources empowered by new insights regarding the tasks to be achieved and the available innovations in the market. Connected health IT will need to be simple to use, affordable, supportable, and capable of protecting privacy. Supplying cross-institutional and cross-professional communication of structured, computable health data will pose significant challenges to providers, but there is evidence that we're making significant progress both in the technology and its standardization.