As many physicians and practice managers are aware, the advent of managed care and a nursing shortage due to institutional demand and retrogression in the U.S. ushered in an era of enormous expansion of career paths for  secondary school graduates and GED recipients in Allied Health.  These positions include Clinical Medical Assistants, Medical Office Assistants, Certified Nursing Assistants and Vocational Nurses.  In an effort to transform health care and deploy interoperable "green" health information technology, the education of these front-line, certified paraprofessionals in medical office workflow using health-IT becomes fundamentally important to the overall success of national implementation.