Health systems spent years, and often hundreds of millions of dollars, moving the clinical record into the EHR. But the paper never fully went away. Forms still sit at nursing stations, live in shared drives, and move through workflows that depend on printing, scanning, and manual updates. This eBook explains the “forms gap,” why it is usually bigger than organizations realize, and how its costs hide across operations, finance, compliance, and revenue. It also shows why building every form in the EHR, buying a pre-built library, or using PDF and eSign tools falls short, and what a scalable, governed approach looks like for growing health systems.