The use of an electric typewriter was a thrill experienced only in college. For my colleagues who are younger than a certain age, typing is a skill in development before preschool. Despite years of work and millions of emails, I can rarely look up at the screen while typing. My only solace is that, unlike my children, I can spell, a skill they claim is obsolete. For this group of 20 to early 30 somethings, the Internet has been omnipresent. There is no need to claim discovery or invention of the Internet for them—it has always been. For me, typing is a skill learned in high school on a manual typewriter.

I reveal this not so well-kept secret as my practice makes its way toward a fully integrated electronic health record (EHR). EHRs are here and they are staying. As the demands for increased accountability and documentation drive payers into pay-for-performance, the electronic medical record (EMR) becomes essential. The billing office seeks as its holy grail an integrated system that captures encounter charges with administration codes, patient’s insurance information with other demographics, and real-time drug expenditure costs.

This uneasiness will fade with time and even now I remain committed to this process of integrating a full EMR into my practice even though it is unsettling. I can’t help it; I am officially a dinosaur.