His company is on track to have more than 60 employees by year-end, up from 50 now and about 40 a year ago. Part of the growth is expected to come from sales of EHR systems to cruise lines to help them handle health records of passengers and crew. “We’re in talks with the top five cruise lines,” he said.

Business conditions are likely to improve further for companies like IOS as more doctors and patients get comfortable with online access to electronic health records. “We’re still at that psychological threshold. We’re not quite there yet. But I think it’s just a natural progression of the industry,” Carricarte said. “It’s the same fear we felt when banking went online. Everybody was worried that their money would be stolen, and look what happened: Everybody is doing online banking.”

Leading the way

Many hospitals have been leaders in adopting electronic records and cutting the healthcare industry’s dependence on costly paperwork. Physician practices have taken a more mixed approach. While many doctors have graduated to modern EHR software systems, many others still use outdated computers and paper archives to store patient information, making records difficult if not impossible to search and send. But the trend toward an increasingly paperless healthcare industry appears inexorable, not only because the federal government is demanding it but also because patients are benefiting. Indeed, higher-quality patient care is one of the main selling points in the EHR software business.

Dr. Sack said the EHR system she bought from Kansas City, Mo.-based Cerner Corp., one of the industry’s biggest vendors, empowers her to deliver timely care even when she’s away from her office near Baptist Hospital of Miami. Among other features of Dr. Sack’s new EHR system, results of patients’ lab tests at remote locations automatically appear in her own records. “I can access my records anywhere. I could be in Timbuktu and know what’s going on with my patients,” she said. On a recent weekend, Dr. Sack said she saw “something critical” in fresh lab-test results on her home computer and immediately arranged for treatment of a female patient that “saved her from winding up in an emergency room.”

Miami-based CareCloud is probably the biggest player among EHR vendors with roots in South Florida. CareCloud and other EHR system vendors sell software as an online service, alleviating physicians’ need to install, maintain and update software on computers in their offices. Many doctors pay a monthly subscription fee of several hundred dollars to keep their electronic health records in a so-called “cloud,” or a remote data center, where they are retrievable online.

Privately held CareCloud, started in 2009, doesn’t disclose its revenues. But the company’s president and CEO Albert Santalo hinted that the top line is approaching $100 million a year. “We’ve been on a triple-digit growth path since inception,” he said, “and we’re getting close to crossing over eight digits in revenue.”

CareCloud has about 170 employees and expects to grow to 300 employees by year-end; it will make most of the new hires in Miami, where the company has 150 employees now.