RT Journal
A1 Shortell SM, Casalino LP
T1 HEalth care reform requires accountable care systems
JF JAMA
JO JAMA
YR 2008
FD July 2
VO 300
IS 1
SP 95
OP 97
DO 10.1001/jama.300.1.95
UL http://dx.doi.org/10.1001/jama.300.1.95
AB 
At the heart of the challenge is transforming a 19th-century craft-oriented delivery system to provide 21st-century biomedical science and technology. Most physicians still practice alone, in partnerships, or in small groups. Small practices generally have less capacity to implement electronic medical records, less frequently use teams to care for patients with chronic illness, and are less able to provide statistically reliable and valid data on quality and efficiency measures. A more solid foundation of physician organizations is needed to avoid having the system crumble under the increased weight of greater demand for care and technological advances.