The document discusses the complex and changing landscape facing the healthcare industry. It notes the many ongoing reforms, regulations, and shifts affecting areas like ACOs, PCMHs, HIEs, reimbursement models, and more. This creates challenges for customers in making purchasing decisions from over 350 EMR options and integrating new technologies. It also places resource constraints on HIT companies to adapt to new products, competition, and customer needs. The document argues that to be effective in this dynamic environment, companies need to change how they respond to quickly, flexibly, and effectively address markets, customers, and opportunities.