An organization working on improving access to its rheumatology department tested a change by having the physicians type all consult responses directly into the computer system at the time the patient is seen, instead of writing in a patient’s chart. Several efficiencies are gained: less use of paper materials, immediate access to lab results and old notes, ability to look at what other consults have been requesting and the outcome, ability to look at x-ray results, and ability to re-read the physician’s own notes prior to writing the assessment and plan.