EHRs

Electronic health records (EHRs) are digital versions of patients' medical histories that are stored and accessible electronically across healthcare settings. Unlike a paper chart kept by a single clinician, an EHR is designed to be shared among authorized providers and organizations to support coordinated care over time. Core data include patient demographics, problems, medications, allergies, immunizations, laboratory results, imaging, vital signs, progress notes, treatment plans, and preventive care timelines.

EHRs support functions such as clinical decision support, computerized physician order entry (CPOE), e-prescribing, results reporting, and secure messaging. They often include patient portals, which give patients access to portions of their records and appointment scheduling. Interoperability standards, such as HL7, FHIR, and CCD/C-CDA documents, enable data exchange between different systems, though enactment of full interoperability remains incomplete in many places.

Regulatory and policy context: In the United States, the adoption of EHRs accelerated after the HITECH Act and the Meaningful Use program, now known as Promoting Interoperability. Privacy and security are governed by laws such as HIPAA, with requirements for access controls, audit trails, encryption, and breach notification.

Benefits and challenges: Potential benefits include improved legibility of records, reduced duplications, better medication safety, enhanced care coordination, and population health analytics. Challenges include high implementation and maintenance costs, workflow disruption, data entry burden, usability concerns, alert fatigue, and persistent interoperability gaps.

Impact and usage: EHRs are used across hospitals, clinics, and integrated health systems. Major vendors include Epic, Cerner, Allscripts, and MEDITECH, among others. EHRs continue to evolve with patient engagement features and advanced analytics, including population health management and precision medicine.