just a thought re your estimate of maintaining a paper chart - you might be underestimating the costs of maintaining a paper chart.
in primary care, the chart is touched often. The associated labor costs, material costs and direct and indirect storage costs make a compelling argument in favor of AC as an EMR (AC annual fees, IT maintenance fees and hardware costs) even if there were no threat of future penalties or short term bonuses from insurers.
It may make sense to replace your paper charts with AC .. even if AC served only as a repository of imported items -
