Caption: : Value Based Purchasing is riddled with challenges due to the overall complexity of the changes and calculations… so staying abreast of the requirements each year is certainly a challenge, along with having to keep key stakeholders up to date. Other challenges certainly include the resources and costs necessary to manage the implementation of a program. There are also challenges associated with the response rate of the survey – how do we effectively engage the patient in responding to the survey? This of course, makes it difficult to engage the staff and physicians (in particular) in the survey process as the limited number (the ‘n’) responses makes it difficult to convince them of the credibility of the information. The number of questions on the survey certainly plays a part in this… not to mention that, as consumers, we are often being asked to ‘rate’ our experience and can experience ‘survey fatigue’. The lag time in data / responses also makes it difficult to have timely, actionable data available … which supports the use of the iPad rounding solutions offered by many vendors.