In addition, clinicians’ computer skill level seemed to be a factor in use of paper processes. One administrator noted: “for the order docs, it’s just easier to jot something down”, implying that the younger, computer savvy physicians are more likely to adopt computer processes. Poor of use, or usability, of CPRS and related heath IT also led to the use of paper. For example, in the acute dialysis unit, usability issues hindered a new computer process intended to automate patient vitals entry into CPRS, and has delayed future roll-out to the rest of the dialysis service. These types of cases, relating to knowledge, skill, and ease of use, were all grouped together in one category since many of these examples related to more than one component (e.g., computer skill level and CPRS usability).