Doctors around the country view improvements in tablet PCs and wireless networks as aiding the adoption of electronic health records. Some who are using tablets say they provide invaluable efficiencies, saving time and money and also boosting the quality of patient encounters (see accompanying story on pg. 25).

While some were worried that the switch from paper charts to digital records and tablet PCs would mean longer patient visits because of the on-the-spot data entry, they are finding that immediate notes save them time, said Jay Anders, M.D., lead physician at the Christie Clinic, a 90-physician multi-specialty medical group with five locations in east central Illinois.

"This is the wave of the future, in my opinion," Anders said. "When I produce a note, I can sign off on it. I never have to see it again."The clinic rolled out an electronic record system from Scottsdale, Ariz.-based

InteGreat about two years ago. About a year ago, it rolled out an encrypted, wireless system from San Jose, Calif.-based Cisco Systems and more recently began distributing Hewlett-Packard Tablet PCs.

The clinic bought 40 HPT 1100 Tablet PCs for its pediatricians who have the heaviest patient load. The pediatricians can access the electronic records during patient exams. Anders envisions giving all doctors and nurses in the clinic the same access eventually.

Mobile access enables the practitioners to use the digital record to its fullest, he said.

He said using digital records will save the clinic about $1 million in transcription and personnel costs by the end of the year.

Rollout of wireless tablet computers is also under way at Marshfield (Wis.) Clinic.

"The mobility that tablet computers gives our physicians the ability to move between home wireless systems, WANs, LANs and makes it easy to negotiate access to other medical facilities," said Carl Christensen, Marshfield's CIO.

Marshfield has developed its own medical record system. The tablet PCs makes the digital records more accessible, said Tom Berg, director of clinical information services for the clinic.

Moreover, "they have returned real value," said Berg – not only to the bottom line, but also in time saved, sometimes as much as two minutes per patient. That adds up for a practice that tallies 2 million patient visits a year, Berg said. Plus, doctors really appreciate being able to take their tablet home, he added.

More than 700 Marshfield doctors and clinicians are using tablets today. By 2006, Berg expects 2,000 will be in use.

Kevin Pitzer, chief administrative officer at Olmsted Medical Center in Rochester, Minn., said tablet PCs complement the center's digital record system.

Olmsted is a 140-member multi-specialty clinic with 10 primary care offices. Pitzer said the center is seeing a 4 percent to 5 percent growth in patients each year. Digital records, combined with tablet PCs, have made it possible for Olmsted to increase the number of patient visits with a minimum increase in staff.

"The economic reality is that we can't see a decline in patient revenue," Pitzer said. "We feel the stronger, long-term savings are yet to come."

Pitzer boasts 100 percent adoption of the tablet PCs at Olmsted, and he credits a phased approach for the success.

Carle Clinic, a 300-physician multi-specialty medical group based in Urbana, Ill., rolled out electronic medical record technology from InteGreat at the beginning of the year, and it is testing tablets from Toshiba.

Bruce Wellman, M.D., the clinic's chief executive officer, expects tablet computers will complement the EMR technology. Doctors especially appreciate that they can be at a meeting and look up a case in real time, Wellman said.

Carle Clinic is a physician-owned multi-specialty group practice of nearly 300 physicians in more than 50 specialties and sub-specialties.

Wellman said the switch to digital records is daunting. He estimates that eliminating paper charts could save the clinic a couple of million dollars a year, but that savings does not cover the millions spent on technology and associated maintenance and upgrades. Still, Wellman sees no alternative.

"The payback is staying in business," he said.