Lucile Packard Children's Hospital has selected the Cerner Millenium product as its electronic medical record (EMR) system and is in the process of implementation. Cerner Millenium provides an integrated architecture that will allow multiple clinical applications to run on a common platform and database. Several other academic children's hospitals are implementing electronic medical record systems to improve accessibility and communication of patients' health records, improve patient safety, provide decision support tools, and offer a rich source of data for clinical research. I will explore the reasons behind the decision to replace the current clinical information system, review the selection process, and the benefits that we hope to gain from the new system. I will also discuss the challenges that we face in implementing such a system in a complex information technology environment.