I have forseen the virtuous cycle 4 years ago and took the entreprenuer route with MD24 House Call Physicians Network. We have finally completed our MD24 platform with proven model, customized with web-based processes for House Call/Home Care then integrate with the VISTA Platform at a conservative cost. Next, we are testing our own web-base PHR and telemedicine interfacing with the VISTA Platform/CPRS. We have successfully launched the VISTA/CPRS in 40+ long term care facilities with our own 9 physicians, performing house call throughout Phoenix Metro. We proudly state that even a small company like us can still leverage the open-source Vista to provide the best quality of care virtually, reaping the incentives from HITECH in addition to a profitable House-Call Business. Supported by the City of Surprise in Ariozna and Arizona State University SkySong, we are also selected by American College of Physicians Executives for sharing MD24′s story. Again, all of these accomplishments were done through VISTA Platform. We have fortunately used a free customizable open-source stable VISTA for our virtual physicians, therefore save our money and provide the best quality of care for our own patients!!!!!!!!!!!!!! We think about the values of our patients first, not trying to pay certification/outrageous software, then working on having enough data to share better outcome with the American College of Physicians Executives. Linh C. Nguyen, MD, MS, MMM