In 1991, the National Academy of Sciences' Institute of Medicine defined, endorsed, and called for the implementation of the computerized patient record (CPR) by 2001. Seven years later, in 1998, health care is still arguing about what a CPR is, how it's to be implemented, and when. This article discusses the origins of the CPR and its initial development efforts. It explores the roadblocks that stalled its development and how managed care may have jump-started the process. Finally, it explains current CPR development efforts and what's on the horizon.