Experts and physician users offer advice on better electronic health records system selection, implementation and operation. Learn more about the costs and the process of going paperless.

"It's like somebody trying to give you a really good excuse to keep smoking--there just isn't one, there just isn't," says David Baron, MD, about some physicians' reluctance to switch to electronic health records.

As a solo family practitioner in Malibu and chief of staff at Santa Monica-UCLA Medical Center, Dr. Baron sees the benefits of EHR systems extending from electronic prescribing, to privacy protection, to simple legibility. "Every change is difficult," he says, "but the pros are going to outweigh the cons. The long-term benefits to the patient and to the practice almost certainly favor [records] going electronic."

From the beginning of his transition until now, Dr. Baron's experience with his EHR system has been a reasonably good one. Not everything has gone perfectly. But along with office management software, the EHR application runs his practice and his staff members operate it proficiently. And when the software slips up or bogs down, he has a company he trusts to help him resolve problems.

As it so happens, the path Dr. Baron took while shopping for an EHR system, implementing it and maintaining it follows closely to the route advised by EHR consultants. "I took advantage of a transition in my career," he explains. In 2003, he started a solo practice with two staff members. He researched the EHR field by studying the annual vendor survey printed in Family Practice Management, a magazine of the American Academy of Family Physicians. From there, Dr. Baron started cutting vendors and products from his list by deciding which features he needed.

Then, Dr. Baron asked for demonstrations. He remembers: "Some companies were anxious to send someone to your office to demo the program, some companies want you to [do] an online meeting where they demo it on the phone, and some companies didn't return the phone call, which was a good sign of their customer service."

With a decent idea of which EHR product he liked--ChartWare's eponymous product--Dr. Baron chose to go with separate systems for medical records and office management, and his staff tracked down a business software package compatible with the ChartWare application.

Implementation was a relative breeze, since Dr. Baron's practice was small and brand new. "I'd say it took me about 90 days  to get comfortable, efficient and productive," he says. He declined to say how much he paid for ChartWare, but estimated reasonable startup costs of $25,000 for a small practice needing both hardware and software. "We brought it in for a solo practice way under that," he says.

With a survey by the American Academy of Family Physicians finding that EHR adoption among its members had jumped to 37 percent this year from as little as 10 percent in 2003, more doctors are going electronic. For those colleagues, Dr. Baron's advice is to work with a vendor that is sensitive to practice needs, which in his case meant vendor responsiveness and easily accessible records and archives. He is even happy with the firm's technical support.

Read on for additional tips and insights from experts and other physicians. There's no excuse why your transition to EHR can't be as positive as Dr. Baron's.