Why was Allscripts struggling, in the years leading up to the divestiture? Revenue was consistently down around 5% a year.

They were losing clients, having a hard time retaining clients, and being pushed into smaller markets. Instead of being in large health systems and academic centers, we were pushed down into community hospitals with 50 to 90 beds because we had lost footing in the larger ones, which were all going to Cerner or Epic.

What happens if a hospital doesn't implement these meaningful use upgrades or comply with them?

Initially, hospitals were incentivized with meaningful use money. Later, reimbursement penalties were introduced for hospitals that were not digitally mature. Some smaller, critical access hospitals were not affected, but in general, there was an expectation from Washington that hospitals would become digitally mature and be able to transact certain information to patients, such as visit summaries and discharge information.