Aug. 24--It's a ritual that's as much a part of seeing a doctor as sticking out your tongue and saying "Ahhhh." A medical assistant searches along a wall of shelves crammed with manilla folders. She comes back with a dog-eared file stuffed with hand-scrawled paper dating back to your first measles shot -- your medical "chart."

In the age of warp-speed computers, this old-fashioned method of record-keeping seems like a quaint remnant -- almost unbelievable in a field so propelled by technology as medicine.

But the fact is, the health services industry has lagged at least a decade behind other economic sectors in making the shift to the digital age. In Washington state, as elsewhere, the shift to electronic medical record-keeping has been a slow, painful struggle.

"The health care industry is one of the few that doesn't rely on computers," said Richard Onizuka, policy director of the Washington State Health Care Authority and head cheerleader for the effort to establish a unified and efficient system of digitizing health care in this state.

"Computers have revolutionized just about every other industry," Onizuka said. "What would you think if you went into a grocery story and didn't see scanners on the checkout stands?"

Tacoma-based MultiCare Health System, the South Sound's largest health care provider, is a notable exception.

On Tuesday, MultiCare's pediatric intensive care unit went digital in all aspects of care, from admissions to ordering prescriptions, reporting test results, physician notes and billing.

The pediatric division was a test run for the rest of the massive hospital system, which is poised to make the leap across the digital divide Oct. 14.

The transition hasn't been cheap or easy. According to Florence Chang, MultiCare's senior vice president and chief information officer, the project has taken 10 years and cost an estimated $100 million.

Few argue the benefits. Now, whether MultiCare patients go to Allenmore, Tacoma General, Mary Bridge Children's Hospital or even one of the 9-by-14 foot clinics MultiCare recently opened in RiteAid drugstores, they're instantly linked to a computer system that has all their records, lab tests and medications.

MultiCare's Good Samaritan Hospital in Puyallup will join the network when rennovations are complete in 2010.

Statistics released last October by the national Centers for Disease Control and Prevention show how unusual MultiCare is. The CDC found that in 2006, only 29 percent of office-based physicians in the United States used any kind of electronic medical record-keeping system.

The percentage of doctors who'd made the move to a full electronic system like MultiCare's was much lower -- only about 12 percent of physicians nationwide.

The relative slowness of the health services industry to go digital shouldn't be attributed to inertia, Chang said.

The demands of medicine are so complex, she said, it's taken this long for computer technology to rise to the challenge.

"This is different than selling groceries," Chang said. "When you're dealing with materials, like in groceries or banking, it's very transactional. In medicine there is no black and white. It is art versus science. Every single human being is different. We need the capability to adapt."

'AN AWESOME SIGHT'

MultiCare moved three of its four hospitals into the most basic aspects of electronic record-keeping in June 2007 when it coordinated systems for admissions, patient records and lab results.

Tuesday's shift in pediatrics added capacities for physician note-taking, lab orders and imaging.