The electronic patient record system, referred to as HUGO (Healthcare Under Going Optimization), was implemented throughout hospitals in Southwestern Ontario in 2014. HUGO was designed with the traditional hierarchical approach to care in which the physician enters an order for other care providers to follow. Several aspects of the traditional approach of HUGO that make it valuable for physicians, pose challenges for NPs as autonomous prescribing providers. Key areas requiring improvement for NPs include the limitation of assigning a single “most responsible provider” (MRP), receiving important patient results into their ‘message center’ (an automated results reporting inbox), order designs that limit NPs from admitting and discharging patients, prescribing medications, ordering tests that are within NP scope of practice, and ordering tests through the use of medical directives. As the number of practicing NPs continues to grow and the NP scope of practice continues to expand, it is becoming increasingly important that NPs have a usable and reliable electronic system that easily integrates their role into the computerized patient record system.