Rebooting the Electronic Health Record

Erik J Zhang; Heng Tan; Joseph A Sanford; James D Michelson; Brian M Waldschmidt; Mitchell H Tsai

doi:10.1007/s10916-022-01834-y

Rebooting the Electronic Health Record

J Med Syst. 2022 Jun 7;46(7):48. doi: 10.1007/s10916-022-01834-y.

Authors

Erik J Zhang¹, Heng Tan², Joseph A Sanford³, James D Michelson⁴, Brian M Waldschmidt⁵, Mitchell H Tsai⁶

Affiliations

¹ University of Vermont Larner College of Medicine, 89 Beaumont Avenue, 05405-0068, Burlington, VT, U.S.. erik.zhang@med.uvm.edu.
² Department of Medicine, Division of Internal Medicine, University of Miami, Miami, FL, U.S.
³ University of Arkansas for Medical Sciences, Fayetteville, AR, U.S.
⁴ Department of Orthopaedics and Rehabilitation, University of Vermont Larner College of Medicine, Burlington, VT, U.S.
⁵ Department of Anesthesiology, University of Vermont Larner College of Medicine, Burlington, VT, U.S.
⁶ Department of Anesthesiology, Department of Orthopaedics and Rehabilitation (by courtesy), Department of Surgery (by courtesy), University of Vermont Larner College of Medicine, Burlington, VT, U.S.

PMID: 35670870
DOI: 10.1007/s10916-022-01834-y

Abstract

Justifications for the widespread adoption and integration of an electronic health record (EHR) have long leaned on the purported benefits of the technology. However, the performance of the EHR has been underwhelming relative to the promises of immediate access to relevant patient information, clinical decision supports, computerized ordering, and transferable patient data. In this narrative review, we provide an overview of the historical problems and limitations of the EHR, detail the core principles that define agile processes that may overcome the barriers faced by the current EHR, and re-imagine what an integrated, seamless EHR that serves its users and patients might look like. Moving forward, the EHR should be redesigned using a middle-out framework and empowering dual-type champions to maintain the sustainable diffusion of future innovations.

Keywords: Agile development; Dual-type champion; EHR adoption; Electronic Health Record; Machine learning.

Publication types

Review

MeSH terms

Electronic Health Records*
Humans