Conclusions Patient records are the primary repository of data in the information-intensive health care industry. Although clinical information is increasingly likely to be computerized, the current, predominant mode for recording patient care data remains the paper record. Paper records have the advantages of being familiar to users and portable; when they are not too large, users can readily browse through them. Paper records, however, have serious, overriding limitations that frequently frustrate users and perpetuate inefficiencies in the health care system. Further, the impact of these limitations is growing as the health care system becomes more complex. Modern patient care requirements have outgrown the paper record.