Using a paperless patient registration project, this teaching case demonstrates an application of the six-step approach in developing a business case for an IT investment. More specifically, this case familiarizes students with the process of developing a solid business case by defining business drivers and investment objectives, identifying and structuring benefits and costs, and estimating return on investment (ROI) based on these values. Students learn, step-by-step, the process from raw data collected from organizational records and internet research to complete managerial decisions based on detailed analysis.