The federal government pushed for the adoption of expensive certified electronic health record (EHR) systems as a cost-saving measure, but a recent paper published in Journal of the American Medical Association found no evidence of cost reduction. Researchers from Duke University and Harvard Business School analyzed processing costs at a large institution operating a certified HER. The organization was large enough to have a unit dedicated to bill processing, so it would not suffer inefficiencies present in smaller businesses. The researchers found the cost to process a single bill ranged from $20 for primary care to $215 for inpatient surgery, or up to 25% of provider income. By way of contrast, bill processing in Canada is closer to 12%, and credit card processing is only 2% of provider income. As costs of medical administration are rising much faster than expenses for overall healthcare, the researchers observed a large portion of the increases are due to forcing uniformity where it does not make sense and therefore adds no value for patients, employers, or providers.