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Dr. Saju Mathew talks with Annette Stawasz in an exam room at North Fulton Family Medicine in Alpharetta. The facility has dropped paper medical charts in favor of electronic records.

It's a common scene: a teenager and his dad sitting in a doctor's exam room, telling a nurse about the sore throat and throbbing finger that are bugging the boy.

As they describe the symptoms, nurse Audra Hurst starts to do something you might not expect.

Tapping at a touchscreen computer, Hurst takes down details of the boy's complaints - making the symptoms a permanent part of his medical record, even as the software alerts the clinic's radiology staff that an X-ray is needed.

While most doctors linger in a paper-based system that dates to the dawn of file folders, North Fulton Family Medicine in Alpharetta has leveraged information technology in an attempt to improve service and reduce costs.

Since the practice dropped paper charts in favor of electronic records a few years ago, the cost of treating an average patient has fallen from $120 to $78, according to founder Dr. Thomas Bat. Things move so swiftly that his clinic's waiting room is often empty, and there's more of the most precious medical commodity of all - time.

"Now I can sit in the room and listen to the patient," Bat said.

Two years after President Bush called for the universal use of electronic health records in his 2004 State of the Union address, such extensive use of information technology remains a novelty. Fewer than 20 percent of doctors' offices and nearly 30 percent of hospitals have goneat least partly digital, according to various studies.

That's despite growing evidence that the paper charts many doctors use today are too primitive to keep up with the fast pace of modern health care, resulting in increased costs, unnecessary tests, delays for patients and even potentially deadly medical errors.

Although Medicare and Medicaid and other government programs are trying to steer providers toward greater use of health information technology, they are under no obligation to do so.

Cost is one big reason for the low adoption rate; it takes about $32,000 per doctor for a medical practice to switch over, according to a 2005 study by the University of Minnesota School of Public Health and the Medical Group Management Association Center for Research.

There's also concern that current technology won't be sufficient when a national network finally arrives years or decades
from now.

But interest in the idea is beginning to grow as medical providers, insurers and business leaders take note of research detailing the cost savings and better care that advocates say can come with investment in the technology.

"Technology doesn't solve the problem, but the problem is so complex, you can't solve it without technology," said Dr. William Bornstein, chief quality officer for Emory Healthcare.

The Atlanta-based medical group is in the middle of a $50 million transition to a fully electronic system.

Whatever the pace of change, technology is inevitably changing the way patients interact with doctors.

Patients of digital doctors' offices can fill out forms, schedule appointments and get lab results online. Hard-to-read prescription slips are on life support as federal Medicare initiatives push more doctors toward electronic prescribing systems.
Companies like StatCom - one of several medical information technology companies working out of Alpharetta's information-technology cluster - peddle software packages that not only help hospitals move patients efficiently through their facilities but also give nervous families up-to-the-minute information about their loved ones.

And someday - if Bush's vision becomes reality - all Americans and their doctors will have access to their medical records via the Internet.

Technology changes are among the ways government, business and insurers are trying to control rising health care costs.

Making electronic medical records available to all doctors could shave $81 billion a year from the nation's $1.7 trillion annual health care tab, according to a 2005 study by researchers with Rand Corp., a nonprofit public policy think tank.

"One of the reasons health care is so expensive these days is because so many diagnostic tests get thrown at patients because you don't know what care they've received," said David Kaye, senior vice president of marketing and product research for Optio Software, an Alpharetta- based company that sells an electronic medical records system to hospitals.

In addition, wired doctors are less likely to make potentially deadly mistakes, said Dr. David Brailer, the national coordinator
for health information technology at the Department of Health and Human Services in Washington.

Many electronic medical records and related programs automatically check for common problems, such as drug conicts.

"There are 78,000 drug interactions, " Brailer said. "I personally can remember 50."

Why haven't more providers made the switch?

"No one thinks it's not a good idea," said David Lansky, executive director of the Personal Health Technology Initiative of the Markle Foundation, a New York-based nonprofit information technology group.

"There are two sets of concerns [expressed by doctors]: Who's going to pay for it, and is it me?"

The Rand study estimated it will cost $115 billion to convert nationwide, and who will pay for that has yet to be decided, but Medicare is likely to play a prominent role.