The demand for information for health care is increasing exponentially in volume, content and the number and geographical distribution of users. Most HIS systems commercially available today are based on designs and philosophies of the 1970s. Even though new technology has improved these systems' performance, to meet current demands, concepts must be shifted from the paper-driven system to an electronic system in which the patient is the focus. We need a merger of the functionality of existing systems along with new functionalities and a computer-based patient record. These new health care information system must have no boundaries; data collection must permeate all locations at which a patient receives care, and seamless linkages must connect all individuals who contribute to that patient's care. Even though systems are being designed today to meet these expanded informational requirements, we will not see such systems in use before the next century.