CLiNiCALLY uSEFuL ELECTRONiC HEALTH RECORDS: A ViSiON FOR THE FuTuRE

Introduction The promise of an effective, clinically useful electronic health record (EHR) has been discussed for decades. The Institute of Medicine (IOM) Report, “To Err Is Human,” discussed the central role of the EHR to reduce errors and promote efficiency while improving quality.1 Significant electronic system development began in the late 1990s but has continued to fall short in producing a system that meets clinical needs. Many systems are little more than an electronic version of the paper record. Decision support functionality may be imbedded, but current systems fail to be clinically useful because they dramatically slow work flow. Despite these flaws, the question is no longer if but when one will adopt an electronic system. In 2004, President Bush, by executive order, set up the Office of the National Coordinator for Health Information Technology (ONCHIT) within Health and Human Services (HHS).2 The charge was to promote electronic health record adoption and interoperability. Despite all the hy...