The U.S. healthcare industry is rapidly replacing older clinical systems with integrated, certified systems to meet "meaningful use" goals and secure federal funding. While the effects of initial system implementation are well understood, less is known about the impacts of mandated system replacement, and some projects will inevitably fail. One such project sought to replace a highly-rated Emergency Department Information System, Wellsoft™ EDIS, with the enterprise Electronic Health Record, Soarian™ Clinicals version 3.3. However, this replacement project failed, and the new system was never implemented. The failure was evaluated qualitatively using a socio-technical framework.