At 4 a.m. on December 2, 2017, St. Joseph's Healthcare Hamilton – a multi-site, clinically diverse, tertiary academic and research hospital – deployed an electronic health record (EHR) system across the organization using a “big bang” approach. This effectively required all inpatient, emergency and many ambulatory services to put down their pens and document everything electronically at one moment in time without skipping a beat in providing excellent clinical care. The hospital leapt from the bottom to nearly the top of the internationally recognized measurement for EHR adoption – on time, in scope and within budget. This article presents the leadership's view on essential lessons learned with key recommendations for healthcare systems seeking successful implementation with this approach.