Book excerpt: Rethinking Return on Investment: The Challenge of Accountable Meaningful Use offers a timely exploration of the value achieved through the Meaningful Use of electronic health records and other components of the HITECH legislation. The authors provide a look back at how ROI of health IT has typically been measured and explore how Meaningful Use regulations are driving healthcare organizations to adopt a value-based purchasing model--thus challenging readers to rethink how they define the ROI of health IT. The authors examine Meaningful Use within a three-stage Value Management Framework: value identification, value realization and value optimization. To assist organizations in evaluating how to drive value out of an investment in people, processes and technology, the book includes numerous value maps for measuring a project's benefits, such as quality improvement, care management and cost reduction. The authors conclude by setting the stage for how the current impact of Accountable Meaningful Use will continue to transform the healthcare delivery system for years to come.