Indeed, the limitations and shortcomings of electronic records were outlined in a recent New England journal of Medicine commentary. These included copied, repetitive notes that desensitized clinicians to new, important data and more attention directed to the computer, which may result in less attention directed to the patient during patient encounters. There types of scenarios may lead to paper-based workarounds. For example, Hartzband and Groopman presented an anecdote of a colleague who, to manage copied, repetitive electronic notes, used index cards to handwrite new developments so that he could refer to them at the bedside. The underlying issue contributing to the use of paper index cards as a workaround in this example may also be related to the way documentation is performed in the EHRs,such as excessive copying from previous notes, rather than simply the apparent convenience of the paper cards themselves.