The recent release of the Bright Futures Guidelines, third edition, brings new opportunity and new power to our work with children and their families. Pediatricians, with their colleague nurse practitioners and family physicians, now address "new morbidities" of behavioral and psychosocial problems, developmental disabilities, and environmental stressors, in addition to the traditional morbidities of infection or malnutrition. Properly designed EHRs can add efficiency to this important work. Schor has discussed the changing nature of the health supervision encounter. If these well child visits are to remain relevant and vibrant, if clinicians are to effectively address the physical, emotional, and social health needs of our children and adolescents, new models of data management are essential. This is the challenge in the development of electronic health records for the primary care of children and youth.