[영문]In the third stage of electronic medical record development, key features of EMR systems have converged, making them more difficult to differentiate from a cost/benefit standpoint. Fourth stage EMR systems are likely to introduce new, more effective decision support capabilities, offering a competitive advantage to hospitals that use them. Intermountain Health Care?s HELP systems, which developed along different paths than other early EMR systems, offer unique decision-support capabilities that provide significant additional benefits. This paper quantifies and compare the benefits of Third Stage EMR systems, and the possible Fourth Stage capabilities of the HELP.