This case set focuses on a health system undergoing transformation and change. In 2015, Mary Washington Healthcare is the latest health care organization to plan to upgrade its electronic health record (EHR) system. The new CEO, Mike McDermott, MD, is considering which vendor to choose: Cerner Corporation or Epic Systems Corporation. This A case includes a brief history of EHR systems, including new regulations, their impact on demand, the state of the market, and the myriad benefits and challenges associated with implementing EHR systems. Students have the opportunity to evaluate the business case for two different EHR systems, as well as to consider the decision’s effect on different stakeholders, such as the board, practitioners, and patients.