HITECH Act's provisions to drive adoption and meaningful use of Electronic Health Records (EHRs) holds great promise in supporting improvements in the quality, efficiency and effectiveness of care delivery. Replacing paper-based processes with electronic ones will have profound implications on both how care is delivered and how workers in healthcare organizations perform their jobs. With the introduction of EHRs, it is vitally important that EHR developers and healthcare organizations design, develop and implement EHRs in such a way that supports meaningful use by all users, including those with disabilities, and not introduce a "digital divide." While EHRs are principally used by healthcare workers, patients interact with these systems directly (e.g. shared use of a display in an exam room) and indirectly through their outputs. To gain the intended benefits of this technology, EHR systems must display or deliver information in a manner and structure that is suitable for their needs and preferences. Therefore, it is vitally important that EHR developers and healthcare organizations implement meaningful use requirements and other functionality involving patients in a way that supports the patients, populations and communities that they serve. This project will provide technical guidance for EHR developers and healthcare organizations regarding the design, development and implementation of EHR systems to prevent the creation or exacerbation of "digital disparities" with the national adoption and utilization of EHR systems, in the workplace and among patients. Through identification and application of best practices, guidance and standards in software usability and accessibility, system developers and healthcare organizations can ensure that EHR system support meaningful use by users that reflect the make-up of the healthcare.