Solving the 50-Year-Old EHR’s Midlife Crisis: How Platform EHRs are Finally Delivering Clinical Intelligence -

Over its first 50 years in existence, how did the EHR lose its way?

Given that EHR adoption doubled between 2007 and 2012 and EHR expenditures in the United States grew an annual average of 5.4% from 2015 to 2019, totaling $14.5 billion in 2019, this may sound like a strange question to ask. But it’s earnest, and asking it acknowledges that electronic health records, first conceived and implemented during the presidential administrations of Lyndon Johnson and Richard Nixon, haven’t lived up to a half-century of promise.

The vision for the EHR was simple but powerful: Provide a longitudinal electronic record of patient health information, inclusive of patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data, and radiology reports, to automate and streamline the clinician’s workflow. What isn’t stated, but is implied, is that the goal of the EHR is to improve patient outcomes.

One could reasonably argue that not being explicit in tying the adoption of EHRs to patient outcomes is the digital record’s fatal flaw. While EHRs were once lauded as the best path to data sharing and improved decision support, they are now perceived by many as rigid billing tools that place administrative compliance above patient care and that create customer lock-in between the vendors that sell them and the care facilities that deploy them.