Dialysis providers use computers to automate complicated tasks, ease staff burden, and develop knowledge or understanding to improve operations and patient care. Some applications are successful, others are not. Success can be economically quantified. Business – billing and accounts receivable computerization – can yield over USD 5.00 for USD 1.00 invested. The clinical case is more complex and difficult to economically justify. Computerization of clinical information for charge capture is the simplest application (< USD 1.00/treatment) yielding the greatest benefit. Economic benefits for improving quality of care through electronic medical records are more problematic. Provider benefit of clinical computing is strictly the net income from more dialysis treatments. Greater complexity – e.g., total electronic records – means more expensive systems and increased staff effort. Many systems cost in the USD 5.00 + range which must be paid by increasing provider overhead. Dialysis providers must determine the point where computerization no longer decreases operational costs as computing cost increases. This is a classical optimization problem; its solution is crucial to the economic health of the dialysis enterprise.