NetCARE is Canada's first region-wide electronic health record (EHR) (Hospital News 2004). It is a clinical, web-based, view-only record of an individual's key health information drawn from multiple sources. NetCARE is available in both hospital and community settings and is accessed by a variety of clinical users. A systematic evaluation showed that an average of 88% of respondents agreed or strongly agreed that netCARE provided valuable lab test results, event history, diagnostic imaging and transcribed reports. Seventy-six per cent indicated that it helped provide quality patient care, and 82% felt it integrated easily into their clinical workflow. A 15-fold increase in EHR use over two and a half years was accompanied by a 56% decrease in physician use of a major legacy system (p=.004) and an average decrease of 24% in requests for paper-based records (p=.03). The average time for netCARE to decrease both legacy system use and patient-chart requests to desired levels was two years.