While EHRs may enhance how data is documented and organized, paper-based processes are not necessarily inefficient or inferior to corresponding computer processes in the EHR. Indeed, for many examples in this study, paper helped some clinicians be more efficient in their work. Campbell et al. notes that “paper often serves as a necessary, sometimes superior, cognitive memory aid” [3]. However, many of these processes circumvent the intended us the computer system and increase the opportunity for losing clinical information. Further, workaround strategies may increase efficiency but create new paths to medical error [25]. Therefore, a welldesigned EHR should support the use of important paper supplementation while minimizing the potential for gaps in EHR documentation.