Rappahannock General Hospital is a 76-bed, not-for-profit hospital opened in 1977 to serve the 60,000 residents of the Northern Neck and Middle Peninsula regions of rural eastern Virginia. Located in Kilmarnock, VA, RGH offers a full range of medical services, including acute inpatient care, 24-hour emergency services, home care, and skilled nursing. RGH has assembled a powerful alliance of provider and business partners to assist in the planning and implementation of a health information technology (HIT) infrastructure that will enhance quality, patient safety, and efficiency of care delivery. These partners bring together a wealth of experience and expertise in program development, care management, information technology, provider collaboration, and research. Traditional efforts to improve quality and patient safety involve automation within specific provider entities, such as hospitals, pharmacies, and physician practices. In contrast, however, this initiative will plan for clinical automation that provides key linkages across providers, enhancing quality and patient safety across the continuum of care. Specifically, we will be examining three potential technologies: automation of the continuity of care record for use in patient referrals, hospital admission, and hospital discharge; e-prescribing in physician practices and for hospital discharge medications and long-term care facilities with links to the community pharmacies; and disease registries for managing preventive care interventions and chronic diseases. [unreadable] [unreadable] [unreadable]