Dr. Ann Smith is a physician in rural New York, where she still keeps all of her patient records on paper, in folders, stored in file cabinets. Lately, she has been receiving a lot of information about HIT systems and is trying to decide what she should do about purchasing the software, how she can afford it, and when she will find the time to learn the program and train her staff. Dr. Smith has a heavy workload and is the only physician within an 80-mile radius. She has three nurses on her staff. One of them also serves as the administrative assistant, who answers phone calls. She also has a part-time office manager who handles insurance claims and appeals. Dr. Smith is overwhelmed by the thought of switching to electronic records, and yet she knows she has to do it. She is 40 years old and plans to be in practice for many years to come. Money and time are both tight. With the exception of one nurse, her staff is older and was inherited by Dr. Smith from the previous doctor. Dr. Smith wonders how she will take care of her patients while trying to learn a new system. Yet, she knows, she is under pressure to adopt electronic records for her practice.