Christiana Care Health Services, a health care system based in Wilmington, Del., is running a pilot project to aggregate and compare its data on patient medication history with information from Blue Cross and Blue Shield of Delaware. The results of the project have shown that 50 percent of the time, the insurer had more detailed information about a patient's history -- especially related to filling prescriptions -- than the health group, said Edward Ewen, director of clinical information at Christiana.

Cigna Corp. is measuring how the doctors with whom it contracts meet certain criteria for quality, but it has opted to reward its members with lower co-payments if they use doctors who meet the standards, rather than providing the physicians with financial rewards, said J. Paul Oates, vice president of medical management systems at Philadelphia-based based Cigna.

"Our employers are insisting that we measure performance," he said. "The only way the health care system is going to change is to motivate the consumer."

Cigna currently measures 19 categories of specialist physicians. This year, the company will add primary care physicians and additional specialists, Oates added.

Still, pay for performance can't be the sole factor driving the adoption of EHRs, Brailer said, noting that smaller practices may be at a disadvantage.