The purpose of widespread EHR adoption, as envisioned by the National government in 2008, was allowing a changeover from volume-structured to value-based payments: an electronic infrastructure was needed for measuring quality. At the right time, however, significantly less than 17 percent of physician procedures were using EHRs, and their systems often lacked necessary data-capture capabilities. Given the high up-front side uncertainty and costs regarding potential returns, financial and cultural hurdles to adoption were formidable.Darshana Dadhania, associate professor of medicine and medicine in medical procedures at Weill Cornell Medical University and associate attending doctor at NewYork-Presbyterian Medical center. Dr. Dadhania says that the primary blood test now used to help recognize rejection - - creatinine, which procedures kidney function - - is much less specific compared to the three-gene signature. Creatinine can rise for most reasons, including basic dehydration in a patient, and when this occurs we then should do an extremely invasive needle-stay biopsy to look at the kidney and determine the cause.