We conducted a series of interrelated studies to understand primary care physicians' experience with adopting physician office systems. Physicians' electronic medical record (EMR) adoption experience is affected by the degree to which physician office system functionality integrates with practice workflow. A financial analysis was used to quantify the socio-technical costs of adopting the EMR. The duration and cost of the adoption period depends on the fit between the physician office workflow and the physician office software. The type of implementation approach also has an effect on the adoption duration and cost. The socio-technical cost of the adoption can be calculated by examining the lost revenue due to reduced billings during the transition period. For practices that ultimately realize an increase in patient volumes, the payback period can be calculated by comparing any incremental increase in patient billings to the socio-technical cost.