U.S. physician offices are experiencing a revolutionay change in the micro-processes that have been the norm for documenting and communicating patient care over past decades. While this revolution is welcome for dozens of reasons, migration of data storage from the paper-based record to electronic form has effects on physician work that go well beyond what is immediately evident. Creation and implementation of these new systems is a huge challenge to all involved, particularly physicians and information technology professionals. This three-part series looks at underlying organizational and sociological aspects of the paper-to-digital transition causing implementation delays and considerable stress. These aspects often go unappreciated during electronic medical record implementations.