Like a handful of others nationwide, the Indianapolis hospital has traded its once scattered medical charts, file folders, X-rays and other documents for a unified electronic records system accessible with a few keystrokes.

Federal officials who are trying to persuade more hospital executives to go "paperless" say electronic records can make hospitals more efficient, reduce medical errors and lower healthcare costs.

The costs of the transition can be high, and many physicians are also unwilling to trade the ease of jotting down paperbound notations of their patients' statuses for a system that requires them to type the same information into a computer.

But in many ways, digital records are a leap ahead for a system rooted in cumbersome 19th century filing methods.

The Indiana Heart Hospital's year-old digital records system allows Gamache, a cardiologist, to show Kolby an X-ray movie of his beating heart just after he was admitted the day before with a clogged artery and in excruciating pain.

"Do you see that right there?" she tells Kolby gravely, pointing to the looped movie of the blockage displayed on a flat-screen computer in his room. "I'm not kidding, they have a name for these and they're called widow-makers."

Kolby, of New Palestine, Ind., watches the digital movie quietly with his sons Tyler, 14, and Caleb, 12, then observes, "That must have been the pain I was feeling." He tells Gamache he's feeling wonderful and is glad to be alive a day after a surgeon reopened the blocked artery by inserting a stent.

After the checkup, Gamache sits down at a computer outside Kolby's room — one of 650 spread across the 88-bed hospital — to enter notes and order changes in his blood-thinning medication.

And all of it without the typical paper trail filled with scrawled physician handwriting.

Despite its digital records system, which cost $15 million to implement, the hospital is not fully paperless.

It still generates paper so that it can interface with the majority of the medical community that remains burdened with paper-filled records rooms.

To cut that paper load and meet President Bush's goal of making sure most Americans have computerized medical records available within 10 years, the federal government is trying to move things along.

On July 21, Health and Human Services Secretary Tommy Thompson outlined a plan that sets technology standards and provides financial incentives for doctors and hospitals to invest in healthcare information technology.

David J. Brailer, the national coordinator for health information technology appointed by Bush in May, said cost has been one barrier, noting that the price tag for the change can run to tens of millions of dollars for a large hospital or network of hospitals. Getting physicians, nurses and medical technicians to abandon years of routine for a new system is another obstacle.

"We don't just automate the old systems — we change the way the work is done. And sometimes there's resistance to change," Brailer said. Younger physicians are less apt to object.

The software, of course, must be reliable and handled with care. A new system at a Department of Veterans Affairs' hospital in Tampa, Fla., was plagued by troubles that delayed surgeries and sparked congressional probes. The VA said last week that it is scrapping that system.

Nearly all hospitals do have electronic billing, but adoption of electronic health records has been slow.

Just 13 percent of hospitals and 28 percent of physicians' practices had some level of electronic health record systems in 2002, according to HHS.

Yet the change appears to carry great benefits.

According to a recent analysis by the Institute of Medicine, the routine use of electronic records could help reduce the tens of thousands of deaths and injuries caused by medical mistakes every year.

Brailer said paperless systems also cut administrative costs by eliminating the need to produce, maintain and store enormous numbers of paper files.

Although it takes doctors longer to enter their patient observations on a computer instead of writing them down, he said digital records save time in the long term.

Tapping into this new data stream could advance even loftier goals.

The Mayo Clinic and IBM Corp., for example, are collaborating on a project enlisting IBM's powerful supercomputers to analyze electronic medical records and quickly assess patients' responses to new treatments for cancer or other diseases.

One drawback that electronic records systems pose for hospitals, however, is that they can reduce hospital revenue, Brailer said.