It's no secret that the majority of U.S. physicians practice medicine with paper and a pencil, and that transition to an electronic medical record (EMR) or electronic health record (EHR) system has the potential to boost efficiency and quality of care.
Why the slow rate of adoption? Many physician practices think they cannot afford an electronic medical record or practice management software system. These offices are overwhelmed by the traditionally high initial costs, including computer hardware and EMR software, installation, training, space, maintenance, support and system upgrades.
But an EMR or a practice management system can be affordable, no matter the size of the physician practice. Here are a few suggestions for how to affordably implement an electronic health record EHR in your office.
Go modular. A modular EHR system enables incremental implementation of an EHR system with a smaller up-front investment. Some physician offices are using online tools for chronic disease, e-prescribing, and registries as starting points for building a full-scale EHR or EMR. 
Opt for phased implementation. Purchase or rent more complex EHR components (e.g., data exchange interfaces) and hardware (e.g., notebook computers) later in the implementation phase.  Implement incrementally by patient, provider, module, or function.
Ditch the traditional, embrace the ASP model. Consider obtaining an Application Service Provider (ASP) based electronic health record software system. Users “rent” access to software, and vendors provide access to data applications. ASP has the potential to reduce costs associated with EHRs, specifically hardware and maintenance. [13,14]
If you're a physician, you've probably also heard horror stories about lost productivity on the heels of an EMR adoption. Many of these stories are exaggerated, although it will take some time (generally 4-12 weeks) to bring you and your staff up to speed with the new medical software system. That's the case with any change.
Physician Offices Slowly Adopt Electronic Medical Record Systems
Time savings from electronic medical records are realized in long-run. Research shows that EHR systems have the potential to save physicians time over time by enhancing clinical processes and workflow; by improving clinicians’ abilities to make sound clinical decisions in a timely manner; by decreasing documentation and dictation time; by improving patient tracking and follow up; by improving the legibility, accuracy, and accessibility of progress notes; by reducing time spent on filing, finding, and pulling charts; by using e-mail messaging; by increasing full integration and documentation of clinical information; and by reducing the time spent writing new and refill prescriptions.
 Meyer, M. (2004). Physician use of e-mail: The telephone of the 21st century. Journal of Medical Practice Manager, 19(5): 247– 51.
 Miller, R. H., & Sim, I. (2004). Physicians’ use of electronic medical records: Barriers and solutions. Health Affairs, 23(2): 116– 26.
 Working Group on Financial, Organizational, and Legal Sustainability of Health Information. (2004). Connecting for health: Achieving electronic connectivity in healthcare. New York: Markle Foundation. Retrieved September 30, 2005, from http://www.hsrnet.net/nhii/materials/CFH_Incentives_Summary.doc