When optimally implemented, electronic health records hold tremendous potential benefit for health systems and can enhance how patient data are documented and organized. EHRs provide improved legibility of patients data;simultaneous, remote access; and integration with other information sources. While some of the potential benefits of EHRs are well-known, they do not produce completely "paperless" processes. Previous research described the phenomenon of "paper-persistence " for medical ordering processes in healthcare organizations where computerized provider order entry (CPOE) was implemented [2-4]. CPOE is only one potential component of many integrated clinical applications in EHRs, and so while implementation of CPOE doesn't eliminate all paper, even if the paper is related specifically to ordering, the intent is to reduce the dependency on paper-based ordering processes and improve patient care. However, even if a completely paperless CPOE system or broader EHRs system were feasible, current limitations of these clinical applications would make a completely paperless system problematic.