As noted above, Access network and regional staff seemed to be confident that they are prepared to make the financial commitment necessary to sustain effective use of EMR. In part, this is due to its size and its ability to realize efficiencies of scale in both start-up and maintenance phases of implementation and use. Return on investment is less certain in Access’s view. Estimates offered by the network remain relatively conservative in terms of savings accrued from the new system, with most savings coming from new efficiencies such as repurposed facilities and decreased costs associated with paper charts. Many staff raised concerns that it may slow down their clinics and limit patient throughput (although others disagreed, arguing that patient volume would return to 80% within a week of go live). One discussant noted that the real savings from the new system will benefit not Access or its centers, but payers who will see reduced costs without significant investments. Some regional managers noted that centers would save on office supplies and network estimates point toward increased revenue from converting chart rooms to exam rooms. Others simply reiterated the connection to Access’s overall mission, asserting that Epic will make Access centers more efficient and increase their ability to provide quality care generally to their patients. While many remain nervous about the new system’s potential impact on centers’ bottom lines, regional leaders expressed confidence that network leaders had adequately considered the financial implications of the move and that their staff would be able to adjust quickly to the new system.