The opportunities for IT in healthcare seem to be endless in this digital economy but research in practice learns that there is a big gap between IT opportunities and daily practice. The Electronic Patient Record is one of those opportunities but it has been so for more than a decade. National initiatives have not lead to nation-wide patient records and local initiatives have not crossed institutional borders so far. This paper characterises EPR in three orientations: administration, medical technology and care process. It describes national and local initiatives that grow beyond one orientation. Four criteria are developed for a successful EPR from the end-user viewpoint. These are relevance, all data available, available to all relevant caregivers and active systems. Our hypothesis is that only an initiative that is found in the intersection of all three orientations can meet all four criteria. The initiative that comes closest to that intersection is tested for these success factors. One important conclusion can be drawn. As long as there is no co-operation of all three orientations there will be no complete EPR and therefore no successful EPR.