Mario Lanza, MD, knew that he needed an electronic health record when he started a family practice in Anchorage, Alaska, in 2006. Having previously worked for a larger group that used paper charts, he was familiar with the endless rounds of chart pulling, filing, the occasional missing or misplaced record, and the stacks of charts on his desk at the end of the day. He knew that he needed a better way to track the preventive and chronic care needs of his patients. And he was convinced that, sooner or later, the government would require all physicians to use EHR solutions.