Dr. George A. Saleh is not scared of new technology, new techniques, or the waves of new information that pour daily from the world of medicine. "I have retaught myself five times since I finished school," says the 56-year-old gynecologist in North Kansas City, Missouri. "I now do advanced laparoscopic procedures that didn't even exist 15 years ago."

So Saleh seemed the perfect candidate for a digital, paperless medical office--a system that allows all records and charting to be done on computer. He took out a loan and bought the necessary hardware and software. And last summer, with his staff of three, he switched everything over to the new system. Patient information was entered on a screen instead of on a form attached to a clipboard; Saleh took notes and made orders using a sleek black tablet PC.

Within days, the office was in meltdown. Patients piled up in the waiting room, and Saleh all but lost control of his day-to-day work. Delays grew so bad, Saleh installed a TV to distract patients, and Cerner Corp., the company supplying his software, trundled in refreshments as a goodwill gesture. "I was running an hour-and-a-half or two-hours late," says Saleh. "That's the kiss of death for your practice. It was crazy."

A few months later, Saleh shows off his file rooms, filled floor to ceiling with paper charts. "No paper has been added to these since summer," he says proudly. Not only is his office back on schedule, but his workday is shorter--and he's seeing just as many patients. "When I walk out of the office each day, I'm done," he says. "I don't have to dictate a stack of charts." His bill for dictation services has dropped from $1,200 a month to $60. His staff is thrilled. "It's like a new era," says medical assistant Jamie Clevenger. "It almost feels like a whole new job."

Using digital medical records allows Saleh to file claims electronically, and quickly; he gets paid by insurance companies in 10 to 14 days instead of one to two months. In an emergency, Saleh can access patient charts from home at night; he can view office records from the hospital. The charts themselves cannot be misfiled, misplaced, or left on the wrong counter--they're safe on servers in a Cerner data center designed to survive the most powerful tornado.

Some of the benefits address problems patients would never consider but that doctor's offices have long struggled with. If a birth control pill or cholesterol drug Saleh has prescribed is pulled off the market, for example, "we can push a few buttons and have a list" of who among Saleh's 7,000 patients is taking the medicine, instead of having to go through those charts one at a time by hand.

Saleh doesn't gloss over the tumultuous weeks of transition. He was slowing things down, trying to type into the computer everything a patient told him. He had to reinvent his approach to keeping track of his patients. Working with Cerner, he now has templates with drop-down menus and autofill categories, along with a place for typed comments. "If a woman comes in for an annual exam, I've got a template for the annual exam. I ask her the questions, and boom, boom, boom, I can pick the correct responses. It's done."