The system trial has now ended and, although the hoped for volume of clinical evidence has not been generated to prove the clinical efficacy of the computerised UECS, a great deal has been learned about the implementation of a concept such as e-medICS.  There are significant cultural and change management issues to be overcome before such a system becomes commonplace.  There is however a great deal of pressure within the Health Service to address these issues and realise the clear benefits of contemporaneous decision support and record creation together with flexible protocol development and delivery and the related potential for remote training delivery.