The journey of electronic health records (EHRs) mirrors my own professional transformation. As a practicing anesthesiologist at Moffitt Cancer Center in the early 2000s, I handwrote paper charts in an era when computers were already integral to other parts of the hospital.
Relying on manual notes was frustrating and inefficient, so I jumped at the chance to help implement Moffitt’s anesthesia electronic record system. This effort sparked an interest in health care IT and my eventual transition to health care IT consulting, where I could make a broader impact by developing solutions to improve the EHR experience for clinicians.
The early days and continued challenges of EHR systems
The concept of EHRs can be traced back to the 1960s, but progress was slow until personal computers and the internet pushed it forward. In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act sought to promote the adoption and meaningful use of EHRs and changed how physicians and patients interacted with data. Several recent factors accelerated the adoption of EHRs, including documentation requirements brought in with the Affordable Care Act and the rapid move toward telemedicine during the pandemic. Since the implementation of the HITECH Act, the percentage of hospitals using EHR technology increased from 10% to 99%.
In the early days, EHRs offered a digital alternative to paper records, primarily focusing on documenting basic patient information. While technology integration improved access to patient data and care coordination, it also came with unintended consequences, such as increased administrative burdens for clinicians. As I’ve worked with health care professionals, a recurring theme has emerged: physicians feel more like data entry clerks than caregivers because of the exhaustive documentation and administrative burden.
EHRs have unquestionably improved health care by offering quick access to patient data, supporting better decision-making, and improving patient outcomes. However, the transformation was not without challenges, and health care organizations did not fully anticipate the realities of clinical workflows.
Throughout my 12 years in health care IT consulting, I’ve encountered countless clinicians who voiced the same concerns: navigating cumbersome EHR interfaces, ensuring compliance with documentation standards, and spending hours searching for critical patient data. Many of them experienced significant burnout due to these inefficiencies. A 2022 Medscape survey showed that specialties such as family medicine, internal medicine, and emergency medicine—which have heavy EHR usage demands—reported some of the highest levels of burnout, ranging from 47% to 60%. In addition, a survey by the American Medical Association revealed that 60% of physicians feel that EHRs negatively impact their professional satisfaction.
Interoperability between different systems has been another significant challenge. I’ve seen the friction when a hospital transitions from one system to another without standardized data formats. Critical patient information often gets lost or misinterpreted, posing serious risks to patient safety and continuity of care. The learning curve for staff is also steep, and initial inefficiencies add to the frustration. However, the benefits become clear over time, and we can see the potential for EHR systems to revolutionize care delivery.
Global solutions for health information sharing
The next generation of EHRs must focus on improving the clinician experience and increasing time with patients to realize a more patient-centered and data-informed future. Advanced analytics, automation, and artificial intelligence (AI) should be integrated into these systems to provide actionable insights directly within the clinician’s workflow. For instance, a heads-up display (HUD) within the EHR could present all critical lab results, vital signs, and clinical notes in a single comprehensive view, improving efficiency and reducing time spent navigating the system.
Beyond AI, EHRs need to be designed to support patient-centered care. With the growing potential of personalized medicine, future EHRs should incorporate genetic and molecular data to enable more tailored treatment plans. Predictive analytics can also provide early warning alerts for conditions like acute kidney injury or sepsis. This would allow for earlier interventions, improving patient outcomes and reducing hospital readmissions.
As the U.S. moves toward the next stage of EHR evolution, we can look to other countries for inspiration:
- Denmark’s centralized EHR system prioritizes user-friendliness and coordination across its national health network. The country has achieved a nearly universal EHR adoption rate among general practitioners, allowing for integrated care and information sharing across health care sectors. Thanks to improved communication and data sharing between health care providers, Denmark’s centralized health network is estimated to prevent 25% of hospital readmissions. Studies also indicate that patients are satisfied with the system, with 80% feeling more informed and involved in their healthcare decisions.
- Canada follows a federated approach where each province has its own EHR initiative, focusing on integrating information across care settings to improve patient engagement. More than 80% of patients who use their province’s portal report improved communication with their health care providers and better self-management of chronic conditions. In regions like Alberta, enhancing interoperability and data exchange in the EHR helped reduce medication-related safety incidents by half and reduced costs from duplicate diagnostic lab tests by 5%.
The next evolution of the EHR
The future of EHRs requires continuous innovation and adaptation. Health care IT leaders must prioritize the development of more intuitive, clinician-friendly systems that meet regulatory requirements and leverage the latest technologies, like AI, automation, and advanced analytics, while enhancing care delivery. Stakeholders, including policymakers, health system leaders, and technology experts, play a critical role in ensuring collaboration to create systems that meet the needs of patients and clinicians.
Reflecting on my journey from handwritten charts to digital solutions, it’s clear that we’ve come a long way. The road wasn’t always smooth and change often felt uncomfortable. But if we can shift from paper records to EHR technology, we can certainly take the next leap toward creating more efficient, patient-centered systems that support clinicians in delivering high-quality care.
Health care leaders need to prioritize innovation in EHR systems not only for compliance, but to improve clinician workflows and patient outcomes. The time for change is now, and the health care industry must embrace the next evolution of digital health solutions.
The EHR evolution has been transformative, but the journey is ongoing. We must continue to drive innovation and make digital solutions more efficient, intuitive, and patient-centered. With the right focus and collaboration, the future of healthcare can be one where clinicians thrive, outcomes improve, and patients receive the personalized care they deserve.
Mike Augustyniak is a physician executive.
