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A roadmap for the future of electronic health records

A new white paper from Stanford Medicine details obstacles and offers solutions for achieving the full potential of electronic health records.

Here is the future of electronic health records:

A digital scribe listens in on patient visits, its algorithm boiling down complex interactions into a concise progress note, no additional documentation required from the doctor.

An artificial intelligence assistant synthesizes data from a patient’s electronic file with medical literature to offer physicians options for optimal care, based on the latest clinical evidence.

Patients use their smartphones to assemble an array of health care apps, uniquely tailored to them, that can communicate relevant information back to their providers.

Sound like an impossible dream? Dean Lloyd Minor, MD, believes it’s within reach.

A new white paper (.pdf) from Stanford Medicine maps out an ambitious vision for the nearly ubiquitous, often-problematic digital documentation systems that have come to pervade the practice of medicine over the past decade.

Drawing from panel discussions and breakout conversations at last summer’s EHR National Symposium at Stanford, the paper details obstacles and offers solutions for achieving the full potential of computerized patient record systems.

Minor explains the importance of tackling EHR challenges in an accompanying piece on his LinkedIn page:

Awaiting an elegant technology fix is an alluring prospect. However, in reality, technology is only one piece of a large and complex puzzle that we must solve in order to arrive at our vision for EHRs by 2028. In the paper, we examine those other pieces and how they fit together.

Over the past decade, as electronic records replaced paper files across the country, providers have encountered a number of headaches integrating the new systems into patient care. A recent Stanford Medicine survey conducted by The Harris Poll details the continuing frustration of primary care doctors across the country — an angst which Stanford professor Abraham Verghese, MD, captures in a New York Times Magazine article quoted by the white paper:

A clinician will make roughly 4,000 keyboard clicks during a busy 10-hour emergency-room shift… In the process, our daily progress notes have become bloated cut-and-paste monsters that are inaccurate and hard to wade through.

Culprits include an array of challenges, ranging from inadequate training to billing inefficiencies, a lack of common technology standards to business incentives discouraging communication among a patient’s providers. The white paper explores all of these issues, while offering an extensive list of recommendations for medical practices, payers, regulators and technologists, to pave the way for improvement. As the white paper notes:

Although EHRs have many problems, there are reasons to believe that they will eventually start living up to their promise. With some changes in technology, regulations and attention to training, EHRs may soon serve as the backbone of an information revolution in health care, one that will transform health care the way digital technologies are changing banking, finance, transportation, navigation, internet search, retail, and other industries.

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