Prior to using athenahealth, I came from a larger practice using paper only for clinical charting. There is a huge difference between EHR and paper. I have come to appreciate athenahealth for all its strength and weaknesses. They always seem to be working on the weaknesses, getting them correct and then a new set of weaknesses pop up because of the never ending changes of the federal government. But all in all athenahealth saves us time and money. You would not have believed that three years ago when it was first implemented. But, athenahealth was always available to the staff when thy ran into trouble.