> How about simply entering in the notes that you write on paper during the exam into your records database when you are done and alone.

Given the training she has received, and the salary she receives, I would prefer her not to be spending time transcribing her notes from one system to another. It will put further pressure on the number of patients she can see. You could employ someone else to transcribe her notes at a salary more reasonable for the work but it is still, or at least should be, an unnecessary overhead.

Digital photos are a good idea although frequently details are sometimes difficult to pick out so I would say it's vital that any system makes it trivial to annotate the images.