As part of the efforts to enhance quality of healthcare, improve efficiency & patient safety, healthcare providers have been adopting health information technologies (HITs), such as electronic medical records (EMR) for decades. In Japan, approximately 66% of major hospitals (with beds more than 399) and 38% of medium hospitals (200-399 beds) adopted EMR by the year 2014.We reviewed studies on the benefits of CPOE (Computerized Physician Order Entry) and EMR. Although benefits of CPOE in terms of reducing healthcare costs, improving quality of care and patient safety have been well documented across various parts of the world, those of EMR have not been clearly shown. In Japan, though adoption rate of HITs by hospitals is in a good track, compared to hospitals of other advanced nations, there is dearth of evidence showing their effectiveness on clinical work processes and outcomes. Systematic evaluation of HITs is crucial to make informed decisions for further investment on such technologies. As a result, we proposed to examine the effect of EMR on clinical work processes and outcomes.In our research plan, levels of patient data shared among healthcare professionals (as measure of clinical work process); and length of stay and 30-days re-admission rates (as measures of outcomes) before and after advancing the existing HIT at Kochi University Hospital will be studied. The hospital has adopted basic EMR (mainly CPOE) since its establishment in 1981 and expanded the system in 2007 to include all EMR systems. This study will compare the outcome variables immediately 2 years before (2005 and 2006) and after (2008 and 2009) the expansion.