diff --git a/.github/workflows/test.yml b/.github/workflows/test.yml
index d400f8b..e880634 100644
--- a/.github/workflows/test.yml
+++ b/.github/workflows/test.yml
@@ -10,13 +10,15 @@ concurrency:
   cancel-in-progress: true
 
 env:
-  DOCKER_HUB_USERNAME: ${{ secrets.DOCKERHUB_USERNAME }}
-  DOCKER_HUB_PW: ${{ secrets.DOCKERHUB_PASSWORD }}
+  GITHUB_PAT_SMILECDR: ${{ secrets.GH_PAT_SMILECDR }}
+  GITHUB_USERNAME: ${{ secrets.GH_USERNAME }}
 
 jobs:
   test-dev-setup:
     runs-on: ubuntu-20.04
     timeout-minutes: 10
+    permissions:
+      packages: read
     steps:
       - name: 👩‍💻 Checkout code
         uses: actions/checkout@v3
@@ -37,6 +39,8 @@ jobs:
   test-local-integration:
     runs-on: ubuntu-20.04
     timeout-minutes: 10
+    permissions:
+      packages: read
     steps:
       - name: 👩‍💻 Checkout code
         uses: actions/checkout@v3
@@ -45,7 +49,7 @@ jobs:
         run: |
           cp env.sample .env
           source .env
-          docker login -u ${{ env.DOCKER_HUB_USERNAME }} -p ${{ env.DOCKER_HUB_PW }}
+          echo "${{ secrets.GITHUB_TOKEN }}" | docker login ghcr.io -u $ --password-stdin
           docker-compose pull --ignore-pull-failures
           docker-compose up -d
 
diff --git a/README.md b/README.md
index 1f7dee7..0f7792c 100644
--- a/README.md
+++ b/README.md
@@ -145,6 +145,14 @@ how everything works.
 Please make sure you have [Docker](https://docs.docker.com/desktop/) 
 installed on your system and it is running. 
 
+You will also need to do the following in order to access the private docker 
+image on Github packages registry:
+
+1. Create a [Github personal access token (classic)](https://docs.github.com/en/packages/working-with-a-github-packages-registry/working-with-the-container-registry#authenticating-with-a-personal-access-token-classic) with `read:packages` scope
+2. export `GITHUB_PAT_SMILECDR=<your token>`
+3. export `GITHUB_USERNAME=<your github username>`
+4. Request access to the smilecdr image: contact Natasha Singh singn4@chop.edu or Alex Lubneuski lubneuskia@chop.edu 
+
 ### Setup
 ```shell
 ./src/bin/quickstart.sh --delete-volumes
@@ -166,21 +174,6 @@ curl -X POST -H 'Content-Type: application/json' \
 http://localhost:8081/keycloak-proxy/token
 ```
 
-### 💡 Important Note About Keycloak
-You may notice the instructions to get the access token are different here 
-in the Developer section than the Quickstart secion.
-
-Unfortunately we cannot send requests directly to Keycloak to get access tokens
-since Keycloak will then use "localhost" in the access token's issuer field 
-(ex. `http://localhost:8080/realms/fhir-dev/protocol/openid-connect/token`).
-
-Then when this access token is sent to Smile CDR inside the docker stack, it 
-will fail since Smile CDR inside the docker network does not know what 
-`http://localhost:8080` is. 
-
-To mitigate this we simply send requests to the proxy service which then 
-forwards the request to the Keycloack docker service. 
-
 ### Inspect Token
 You should get back a response that looks like this (access token removed 
 for brevity):
@@ -249,33 +242,33 @@ https://releases.smilecdr.com/
 
 ### Upgrading to a New Version
 
-Follow these steps to upgrade to a new version of Smile CDR:
-
+### Steps
 1. Download the docker image tarball from the smilecdr releases site ^
 2. Create a new local image from the tarball
-3. Tag and push the image to the kidsfirstdrc/smilecdr repo on Dockerhub so 
+3. Tag and push the image to the kids-first/smilecdr repo on Github packages so 
 that other developers have access to the image
 4. Tag and push the image to both kf-stridess and include ECRs so
 that future deployments have access to the new version
 5. Update the base image in the Dockerfiles (Dockerfile.includedcc, Dockerfile.kidsfirst_upgrade)
-6. Update the docker-compose.yml file to use the new image
+6. Update the docker-compose.yml file to use the new image tag
 7. Push the changes to Github to trigger the deployment and ensure the new
 image works
 
-There are scripts to help with all of these steps. Here is an example of how 
-to upgrade to version 2023.05.R02:
+Run the following scripts to do steps 2-4. Here is an example of how to upgrade to version 2023.05.R02:
 
 ```shell
 # Step 2
 ./bin/upgrade/new_image.sh ~/Downloads/smilecdr-2023.05.R02-docker.tar.gz 2023.05.R02
 
 # Step 3
-./bin/upgrade/upgrade_dockherhub_image.sh kidsfirstdrc:smilecdr/2023.05.R02
+./bin/upgrade/upgrade_ghcr_image.sh kids-first:smilecdr/2023.05.R02
 
 # Step 4
 ./bin/upgrade/upgrade_ecr_image.sh kf-strides-smile-cdr 2023.05.R02
 ```
 
+
+
 ## 💻 Codebase
 
 ## Smile CDR
@@ -348,6 +341,21 @@ time (on docker-compose up)
 - Keycloak clients that have been configured with different FHIR roles and 
 consent grants. These get loaded in at deploy time (on docker-compose up)
 
+### 💡 Important Note About Keycloak
+You may notice the instructions to get the access token are different here 
+in the Developer section than the Quickstart secion.
+
+Unfortunately we cannot send requests directly to Keycloak to get access tokens
+since Keycloak will then use "localhost" in the access token's issuer field 
+(ex. `http://localhost:8080/realms/fhir-dev/protocol/openid-connect/token`).
+
+Then when this access token is sent to Smile CDR inside the docker stack, it 
+will fail since Smile CDR inside the docker network does not know what 
+`http://localhost:8080` is. 
+
+To mitigate this we simply send requests to the proxy service which then 
+forwards the request to the Keycloack docker service. 
+
 ## Web App
 - A simple Keycloak proxy that makes it easy to get an access token from 
 Keycloak whether Keycloak is running in the Docker network or in an external
diff --git a/bin/upgrade/new_image.sh b/bin/upgrade/new_image.sh
index 9c97ac8..7ac1ce6 100755
--- a/bin/upgrade/new_image.sh
+++ b/bin/upgrade/new_image.sh
@@ -9,7 +9,7 @@ START_TIME=$SECONDS
 if [[ -z $1 && -z $2 ]];
 then
     echo "You must supply the path to the docker tar.gz and the image tag to use"
-    echo "Usage: ./bin/$(basename "$0") path/to/tar.gz kidsfirstdrc:smilecdr/2023.05.R02"
+    echo "Usage: ./bin/$(basename "$0") path/to/tar.gz kids-first:smilecdr/2023.05.R02"
     exit 1
 fi
 
diff --git a/bin/upgrade/pull_ghcr_image.sh b/bin/upgrade/pull_ghcr_image.sh
new file mode 100755
index 0000000..41133d4
--- /dev/null
+++ b/bin/upgrade/pull_ghcr_image.sh
@@ -0,0 +1,36 @@
+#!/bin/bash
+
+# Pull a Smile CDR docker image from the Github packages registry
+
+# ./pull_ghcr_image.sh <docker image tag> <github username>
+
+set -e
+START_TIME=$SECONDS
+
+if [[ -z $GITHUB_PAT_SMILECDR ]];
+then
+    echo "You must have the GITHUB_PAT_SMILECDR environment variable set to "
+    echo "continue. This should contain a Github personal access token (classic)"
+    echo "with the appropriate permissions for reading from the Github package registry"
+    echo "See https://docs.github.com/en/packages/working-with-a-github-packages-registry/working-with-the-container-registry#authenticating-with-a-personal-access-token-classic for details"
+fi
+
+
+if [[ -z $1 && -z $2 ]];
+then
+    echo "You must supply the image tag to use and your github username"
+    echo "Usage: ./bin/$(basename "$0") kids-first/smilecdr:2023.05.R02 znatty22"
+    exit 1
+fi
+
+echo "🐳 Docker login to Github package registry ghcr.io"
+echo $GITHUB_PAT_SMILECDR | docker login ghcr.io -u $2 --password-stdin
+
+echo "🐳 Docker pull from Github package registry"
+docker pull "ghcr.io/$1"
+
+ELAPSED=$((( SECONDS - START_TIME ) / 60 ))
+FORMATTED_ELAPSED=$(printf "%.2f" $ELAPSED)
+
+echo "Elapsed time $FORMATTED_ELAPSED minutes"
+
diff --git a/bin/upgrade/upgrade_ghcr_image.sh b/bin/upgrade/upgrade_ghcr_image.sh
new file mode 100755
index 0000000..87f227c
--- /dev/null
+++ b/bin/upgrade/upgrade_ghcr_image.sh
@@ -0,0 +1,40 @@
+#!/bin/bash
+
+# Pushes a Smile CDR docker image to the appropriate repo on Github packages
+# registry
+
+# ./bin/upgrade/upgrade_ghcr_image.sh <docker image tag> <github username>
+
+set -e
+START_TIME=$SECONDS
+
+if [[ -z $GITHUB_PAT_SMILECDR ]];
+then
+    echo "You must have the GITHUB_PAT_SMILECDR environment variable set to "
+    echo "continue. This should contain a Github personal access token (classic)"
+    echo "with the appropriate permissions for writing to Github package registry"
+    echo "See https://docs.github.com/en/packages/working-with-a-github-packages-registry/working-with-the-container-registry#authenticating-with-a-personal-access-token-classic for details"
+fi
+
+
+if [[ -z $1 && -z $2 ]];
+then
+    echo "You must supply the image tag to use and your github username"
+    echo "Usage: ./bin/$(basename "$0") kids-first/smilecdr:2023.05.R02 znatty22"
+    exit 1
+fi
+
+echo "🏷️ Tagging image with $1"
+docker tag smilecdr:latest "ghcr.io/$1"
+
+echo "🐳 Docker login to Github package registry ghcr.io"
+echo $GITHUB_PAT_SMILECDR | docker login ghcr.io -u $2 --password-stdin
+
+echo "🐳 Docker push to Github package registry"
+docker push "ghcr.io/$1"
+
+ELAPSED=$((( SECONDS - START_TIME ) / 60 ))
+FORMATTED_ELAPSED=$(printf "%.2f" $ELAPSED)
+echo "✅ Created new image. Remember to update docker-compose.yml"
+echo "Elapsed time $FORMATTED_ELAPSED minutes"
+
diff --git a/docker-compose.yml b/docker-compose.yml
index d924db6..d90a912 100644
--- a/docker-compose.yml
+++ b/docker-compose.yml
@@ -4,7 +4,7 @@ version: "3.8"
 services:
   smilecdr:
     container_name: smilecdr
-    image: kidsfirstdrc/smilecdr:2023.05.R02
+    image: ghcr.io/kids-first/smilecdr:2023.05.R02
     env_file:
       - .env
     ports:
diff --git a/src/bin/setup_dev_env.sh b/src/bin/setup_dev_env.sh
index 02736cc..95a3322 100755
--- a/src/bin/setup_dev_env.sh
+++ b/src/bin/setup_dev_env.sh
@@ -11,8 +11,8 @@ set -e
 
 START_TIME=$SECONDS
 DELETE_VOLUMES=0
-DOCKER_HUB_USERNAME=${DOCKER_HUB_USERNAME}
-DOCKER_HUB_PW=${DOCKER_HUB_PW}
+GITHUB_USERNAME=${GITHUB_USERNAME}
+GITHUB_PAT_SMILECDR=${GITHUB_PAT_SMILECDR}
 
 while [ -n "$1" ]; do 
 	case "$1" in
@@ -51,16 +51,22 @@ else
     docker-compose down
 fi
 
-# Check docker hub creds 
-if [[ -z $DOCKER_HUB_USERNAME ]] || [[ -z $DOCKER_HUB_PW ]]
+# Check github packages registry creds 
+if [[ -z $GITHUB_USERNAME ]] || [[ -z $GITHUB_PAT_SMILECDR ]]
 then
-    echo "🔐 You need the Kids First DRC docker hub credentials to continue" 
-    echo "Please contact the Github repo admins: natasha@d3b.center or meenchulkim@d3b.center" 
+    echo "🔐 You must have the GITHUB_USERNAME and GITHUB_PAT_SMILECDR environment variable set to continue. "
+    echo "GITHUB_USERNAME should be set to your github username and GITHUB_PAT_SMILECDR should contain a Github personal access token (classic)"
+    echo "with the appropriate permissions for reading from the Github package registry"
+
+    echo "See https://docs.github.com/en/packages/working-with-a-github-packages-registry/working-with-the-container-registry#authenticating-with-a-personal-access-token-classic for details"
+
+    echo "🛂 You will also need to be a collaborator on the repo in GHCR"
+    echo "Please contact Natasha Singh singn4@chop.edu or Alex Lubneuski lubneuskia@chop.edu"
     exit 1
 fi
 
-echo "Logging into Docker Hub ..."
-echo "$DOCKER_HUB_PW" | docker login -u "$DOCKER_HUB_USERNAME" --password-stdin
+echo "Logging into Github packages registry ..."
+echo "$GITHUB_PAT_SMILECDR" | docker login ghcr.io -u "$GITHUB_USERNAME" --password-stdin
 
 sleep 10