Conclusions: The study demonstrates that many processes, systems, services and practices for nation-wide implementation of the electronic locum record for general practitioners in the Netherlands are in place. However, significant improvements are required on a number of aspects. For example general practitioners need to be trained more in applying the guideline for electronic registration of patient data. Also the process for general practitioners to acquire their unique healthcare professional identification cards should require less effort. We also recommend that a strong regional information technology support group should be in operation during roll-out. (Source: International Journal of Medical Informatics).