If your doctor still scrawls in notebooks during a medical examination, or your nurse still scribbles on Post-It notes "” well, Nick Recker is here to tell you that's all about to change.

Recker is founder of Path Forward IT, a Cincinnati-based firm that specializes in converting private practices to Electronic Medical Record systems.

Until this year, that was a true hard sell. "Asking a physician to change the way they practice medicine in order to accommodate an EMR system (could) lead to a challenging conversation," Recker laughs.

Thanks to newly minted federal economic stimulus money, though, those same doctors now have a fresh financial incentive to get rid of their archaic paper charts and switch to electronic medical software systems. For practices that switch to an EMR system, the Obama administration is offering up to $44,000 per physician for offices that bill to Medicare, and $64,000 per physician for offices that bill to Medicaid. Although doctors can continue to use paper invoices, in order to qualify for the incentive, they'll need to produce a computerized summary of all billings at year's end to prove they've switched to an EMR system.

The incentive is part of the American Recovery and Reinvestment Act, signed into law by President Obama in February. The act guarantees that some $20 billion in incentive payments will find their way to medical providers who choose to adopt electronic health records in the coming year.

Medical offices are being paid to enter the 21st century in terms of patient record-keeping, Recker comments, which means that EMR systems can pay for themselves. In essence, the federal government is suggesting that doctors who refuse to go paperless are recording their patients' statistics in the same way their predecessors did in the age of Gutenberg, scribbling on a by-product of dead trees.

Amazingly, only 20 percent of the nation's 650,000 licensed doctors are using electronic patient record systems. Most private practices that use computers do so only for billing individuals, filing health insurance claims and other functions unrelated to primary patient care.

So, Recker's timing couldn't be more impeccable. But then, the entrepreneur has always had a bent for being in the right place at the right time.

"I founded Path Forward in 2002 after working as an independent contractor for a few years," Recker recalls. "As the IT business grew, it became quickly apparent that the real opportunity was to help medical practices as they approached their tech boom."

Recker's good fortune has translated into growing his company to a staff of 30 employees. But that success is no accident. "You must know your industry inside and out," Recker advises, "and incorporate that knowledge into the value of your products and services."

For Recker, the benefits of his product are myriad. According to him, installing an electronic medical record system in a medical practice enables all medical providers to interchange data between systems; alerts physicians to perform a medical test; warns doctors they may have written a prescription for the wrong drug or the wrong dose; lessens the chance a nurse or pharmacist will make a mistake in deciphering a doctor's garbled script; lessens the chance of misplaced patient charts; and better captures charges and decreases billing errors by marrying actual procedures to the output of invoices.

New bar code technology may even make it possible for these electronic safety systems to work beyond an individual practice. A code on a card kept in a patient's wallet or purse could alert emergency rooms and specialists to allergies or to the possibility of unsafe interactions with another drug.

Beyond the practice office, the implementation of EMRs can also have an effect on the patient at home, Recker notes. Individuals can conceivably see their own files via their personal computers or even make and keep track of appointments online. And medical consumers in Cincinnati would no longer have to repeat their entire clinical biography if they had to visit a doctor while on a business trip or vacation in, say, San Francisco.

"It can be difficult to determine which EMR product is best to implement in order to satisfy the practice's specific needs and organizational goals," Recker says.

From Epic to Allscripts, NextGen to GE Centricity and Greenway, there is a virtual sea of software options to navigate. "We help offices review their entire clinical process in preparation for an EMR implementation," Recker says, "allowing (them) to avoid common stumbling blocks physicians often encounter during EMR implementation."

In general, Recker's advice to other entrepreneurs is to challenge yourself and your ideas on a daily basis, to prevent yourself from falling into traps: "Create a diverse advisory team of experienced professionals to review your business plans. Present those ideas to your advisory team as if you were trying to "¢sell' them on your plans. The exercise of preparing for those meetings will make you more meticulous and assure your plans are sound.

"In my opinion, the biggest challenge as an entrepreneur starting a business is being an underdog," Recker concludes. "You must be able to articulate and demonstrate to prospective and current customers why the services or products you provide are better or more valuable than your competition."

Nick Recker, Path Forward IT founder and senior consultant

The Recker File

Born: Cincinnati

Age: 31

Residence: Sycamore Township

Personal: Married for eight years to Heather. Children are Julia, 5, Sophia, 3, and Caroline, 1

Education: Attended Ohio University, Xavier University and the University of Cincinnati, with studies focused on information technology

Other Training: Earned credentials as a Microsoft Certified Systems Engineer

First Business: Launched Recker Consulting in 1998, to serve the IT needs of small to medium-sized businesses

5 Tips for Entrepreneurs

1) Be ready to work. Effort is often the only thing you can afford to drive a new business.

2) Surround yourself with people who challenge you and your ideas. Let your passion and energy drive the business,

but don't become stubborn.

3) Delegate everything you can. If entrepreneurs aren't careful, they can become an operational bottleneck and inhibit the growth of their business.

4) Control your expenses. Every purchasing decision should be considered against how much service or product

you must sell to cover that expense.

5) Always put your customers at the top of your organizational chart. Every meeting, marketing effort and internal communication should reflect a customer-centric culture.