This document describes the successful implementation of health information technology across a rural hospital system including a 76-bed hospital and various clinics, long-term care facilities, and outpatient services. The hospital implemented an electronic medical record system across its continuum of care between 1999-2010 in a phased approach, beginning with core financial and clinical systems and expanding to physician practices, long-term care facilities, imaging, and a patient portal. Key lessons learned included agreeing on a strategic vision, taking an inclusive implementation approach, thorough planning, clear communication, managing expectations of difficulties, and addressing physician needs.