This paper explores how electronic health record (EHR) systems have introduced a new genre for physicians to use (a genre we refer to as check-list) that is used in addition to their traditional narrative genre as part of a single patient health record. Our analysis suggests that it is because the overlap between these two genres is created and used interdependently that breakdowns occur in the coordination of care. We also consider how the medium and the institutional context influences this confusion caused by the interactions between these two genres. We thus contribute to theoretical discussions about genre systems and illustrate the practical insights that emerge from a genre analysis.