Even doctors who have purchased and successfully implemented electronic health records do not always know what they're buying until the system is up and running. ONC director Farzad Mostashari made that point to a room full of chuckles on Wednesday while giving the closing keynote address at the Government Health IT Conference here in Washington. The problem: While there are nearly 750 EHR products certified for meaningful use stage 1, adequate apples-to-apples comparisons of features and prices do not exist today. Competition is a wonderful thing, said Mostashari, but "classic causes of market failure," in this instance prohibitively high switching costs, vendor or data lock-in, among others, weaken the competitive landscape. "We need to create a better marketplace," he said. "We want as little government involvement as possible, but no less."