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With so many vendors and systems, finding the right electronic health record system software is just part of the struggle practices face in the transition from paper to digital.

The U.S. Department of Health and Human Services earlier this month granted a two-year deadline extension to 2013 for the transition from ICD-9 codes to the greatly expanded ICD-10 codes.

If the federal government has its way, a quality reporting initiative from Centers for Medicare & Medicaid Services could pave the way toward establishing a pay-for-performance system.