Electronic medical records (EMR) will be the standard method of medical documentation within the next decade. Making the conversion from paper to digital records will be costly in terms of actual cash outlay for an EMR system and the time investment in staff training, conversion of existing records and loss of operational efficiency during the implementation phase. The most difficult part of converting to EMR is ensuring the system you select will meet your practice's current objectives and those in years to come as technology--and the general population's adoption of it--changes. There are tremendous opportunities for current and future technologies to improve efficiency and reduce practice overhead, but selecting a system with limitations may make it difficult to realize these potentials. My aims are to: (1) explain why an EMR will be important to an orthopaedic practice and establish goals of EMR conversion; (2) outline attributes desirable in an EMR system; and (3) provide some insight regarding future direction of EMR.