Broad Long Term Objectives: ByNet and the non-profit and public safety-net healthcare providers comprising the network share a common mission to improve the effectivness of health care delivery for under and unisured residents. The clinical and organizational objectives to address these needs are (by the end of year three of AHRQ TQHIT Implementation): 1. Organizational: To build upon existing assets by developing a system that allows for significantly enhanced clinical and administrative information sharing among ByNet partners. 2. Clinical: To improve quality and consistency of medical practice and reduce medical errors among ByNet partners. The AHRQ Implementation Project is structured in three basic phases: 1.. Establishing the IT Foundation 2. Building the Bridge 3. Connecting Systems This will be realized through a strong organization foundation with local, state, and national partners committing time and resources monthly to improvement of care. Specific activities include addition of hardware and software to bring organizations to a level state of readiness needed for sharing, beginning with the highest need identifies to bring Electronic Health Records (EHR) to the Critical Access Hospital, the lead applicant. In addition, an IT team, legal, and evaluation consultants will be responsible for building a system that will allow existing systems to communicate, compliant with HIPAA standards, and that increase patient safety and quality.