They don't have an electronic medical record at all. I had no difficulty getting in touch with dr. Sacks 98% of the time but the lack of an emr means he could tell me something and it's not tracked in my paper records and then the nurse doesn't know. This caused errors such as nurse but getting preauthorization as she thought I was doing TI but he told me IUI so had to pay out of pocket. Or after many many weeks of no period following a failed cycle, Dr. Sacks told me to come in anyway as the lack of ovulation and likely pcos was the reason for treatment to begin with, but vshowed up and the nurse asked what day cycle I was and I replied I hadn't had a period in many weeks and in an almost accusatory tome she said why not? Are you stressed? ( which at this point I was very stressed by the lack of a period and ongoing delay of fertility treatment...she called later that day and said you likely have pcos, which Sacks had told me 4 years prior...).