Electronic medical records are gathering significant attention with the recent State and Federal initiatives, Medicare Physician Quality Reporting Initiatives (PQRI), and stimulus funds. The conversion to an electronic environment from the comfortable but inefficient paper record can be confusing, difficult, and costly if the practice does not complete the proper analysis and planning for the transformation. Significant monetary assistance is available for practices during this process, with resultant increased practice efficiency and patient safety. To be successful, the practice must fully understand the expected benefits and must evaluate each of the options to be sure the entire practice workflow is considered.