As complicated as it may seem, certification is not the only approach to evaluating HIT in general and EHR systems in particular. How one assesses a given technology is dependent on the goal of the assessment and how the information will be used. We have discussed some of the different goals of the various EHR certification programs developed to date. As we consider several other useful ways of evaluating HIT, it is important to recognize that they each assess a different aspect of the interaction between the technology involved and its use by clinicians. Taken together, they may be able to truly evaluate the effectiveness of HIT as its use becomes more widespread.