Each case of paper use with the EHR should be examined to understand the potential impact. For example, one physician noted that he relied on a printed medication list from CPRS during the patient encounter so that he could efficiently go through the list, make handwritten notations, and mark which medications needed to be refilled. This important documentation must also be entered into CPRS (including dosage and administration changes) at some point, presumably later in the day. Otherwise these changes would not be reflected in the active medication orders in CPRS for the patient. Ideally, these changes would be entered at point of care without the additional paper-based step to avoid any potential gaps or delays in the EHR documentation