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- Wide geographic variations in business practices—many parts of rural Kansas have few physicians and hospitals, limited health resources, while some cities have considerable duplication
- Few physicians' offices are "wired", there are no RHIOs, little electronicization outside urban areas
- HIPAA has been fully integrated into all stakeholder practices—yet some consider it a barrier, some neutral, and some an aid
- Some physician offices and hospitals have extensive policy manuals, others rely on common practices
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