While a paperless system may not be commonplace today, strides are being taken by groups such as CPRI to ensure the development of such a system. Several hospitals and clinics are moving toward or have implemented paperless or limited paper environments using patient-centered systems where charting is performed at the "bedside" of the patient through sophisticated software and hardware systems. Such systems will continue to evolve until the ATM of patient care is created. At that time, patients' access to their own information will be an acceptable phenomenon, physician use of computers will be commonplace, acceptance that adjunct knowledge bases must be coupled with the human skills of the physician, and test redundancy will be considered intolerable. These steps will contribute to the cost reductions needed to truly "reform" health care and create a value-added product for the United States.