Handoffs-transfer of patient care from one clinician or service to another-are well known patient safety dangers. Healthcare Information Technology (HIT) as an intervening and powerful force in handoffs has received comparatively little attention. The role of HIT in concert with paper documentation has received even less attention. We analyze handoffs in relation to electronic records and hybrid systems (both paper and HIT) to identify sources of error and miscommunication. We propose a typology of handoffs and illustrate several of them.