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In 1999, The Institute of Medicine (IOM) issued a seminal report on the safety of health care in the U.S.: To Err is Human. The IOM noted that up to 98,000 deaths occurred annually as a result of errors in the health care system. They recommended systemic change to improve the safety of the system. One of the recommendations included in the report was to make better use of electronic order entry systems for prescription drugs since handwritten orders were shown to account for a meaningful number of medication errors. Thus began a journey toward more widespread use of electronic medical record systems, with a hope that they would help reduce medical errors and improve the quality and cost effectiveness of care.