The replacement of the paper medical record at Emory will be gradual over the next several years. We foresee milestone events after which portions of the patient record are no longer retained in paper form. As these milestones are identified, the HIM professionals at the three institutions will begin the formidable task of managing the transition to a paperless system. Evaluation of business processes and the skill sets needed by staff members can be accomplished and a plan for each phase of transition developed.