Everyone is building a distributed systems these days, but the "how" has become a matter for religious debate and the "why" is often neglected completely. This panel brings together a variety of practitioners to explain the joys and woes of building a distributed system including: . why a distributed solution was chosen . what middleware was selected and why . what issues and gotchas reared their ugly heads and what was done about it Providing secure electronic medical records over the internet is a continuing challenge to the healthcare enterprise. We discuss our experiences with the deployment of a secure, JavaiCORBA-based multimedia electronic record system in a rural healthcare setting. In particular, issues of scalability, portability, extensibility, interoperability, useability, and quality of service will be discussed in detail.