Today, it’s easy to think of electronic health records (EHRs) (also known as electronic medical records) as just a substitute for paper record-keeping and little else. However, the truth is, great advances have been made in the healthcare field, all combined with a rich history.
The Early Days of EHRs
The history of EHRs began in the 1960s – the Mayo Clinic in Rochester, Minnesota was one of the first major health systems to adopt an EHR.1 In the 1960s, EHRs were so expensive that they were only used by the government in partnership with health organizations. Throughout the 1970s, only the biggest hospitals could use them, and they were used for billing and scheduling.
At the same time, during the 1960s, a new approach to medical records (still on paper) began to emerge. Referred to as the “problem-oriented” medical record, this approach added more robust information about the patients and over time evolved to become the medical records we see today. This approach was a breakthrough in medical recording. Previously, doctors had typically only recorded a patient’s diagnosis and the treatment they provided.
As part of the “problem-oriented” medical record, clinicians began collecting and storing data about a patient’s history. When properly implemented, this model provided a more effective means of communication among members of healthcare teams, while also facilitating the coordination of preventive care and maintenance. As EHRs became more affordable and available in the 1980s, they were developed with fields that could be filled in with clinical information and stored as an electronic record.
How Portable Records Became Electronic Records
With portability came the dawn of the computer era. Many of the earliest computer applications in the 1970s were in use at hospitals and government institutions, but very few other places. At first, these applications were used more for billing and scheduling purposes, and not EHRs specifically. 2 Then, thanks to the portable medical records model, large hospitals started to provide the same level of service for each patient without worrying that only specific providers had knowledge of that patient.
Computers, of course, really didn’t gain traction in smaller facilities and private practices until they became popular with the general public. Before the 1980s, it was rare to see a computer used at all in private practice, let alone for storing medical information. Even though the portable record-keeping system had become far more commonplace, records were largely paper that had to be physically stored and moved.
Business technology then became advanced enough that even paper records could be sent electronically, via fax, in cases where an office needed to get in touch with a patient’s family doctor in case of urgent care. But time is often of the essence in most caregiving scenarios, and because of this, the electronic system became the standard. Medical providers realized that in every medical specialty, from urgent care to rehab, there were always unique cases that had to be resolved electronically.
The Internet and the Rise of the EHR
By the 1990s, technology had entered most medical offices, and computers were being used to a limited degree for record-keeping purposes. Specifically, EHRs were mostly seen at academic inpatient and outpatient medical facilities, and they included data interchange for claims processing and image scanning for document capture.3 But it wasn’t until the age of the internet that large-scale change became far more visible. Even in its early stages, the internet became a vital tool for recording and transferring prescription histories and other medical records. Finally, within the last decade or so, most major medical systems in the developed world could easily communicate with each other when needed.
Electronic Health Records Today and the Future
In 2004, President George W. Bush created the Office of the National Coordinator for Health Information Technology, which outlined a plan to ensure that most Americans had electronic health records within the next 10 years. 4 Additionally, these records were designed for healthcare providers to:
- Share information privately and securely with the patient’s authorization
- Help health care quality, prevent medical errors and reduce paperwork
- Improve administrative efficiencies and health care quality
As it is now, EHRs are increasingly paperless, although some private practices continue to use a combination of paper-based and computerized records. Patient records are more accessible than ever before with data technology becoming increasingly portable and comprehensive. Current refinements in the medical records industry are aimed at the continued specialization of systems to further streamline workflows, boost productivity and improve doctor-patient interactions. And so, it seems that EHRs will continue to make a mark in the healthcare industry for years to come.
After several years of developing software solutions for a variety of healthcare organizations, Net Health is now leveraging the data within its specialized EHRs to provide insights that improve clinical decision-making through predictive analytics driven by predictive analytics algorithms. Learn more.
1 Becker’s Hospital Review, “A History of EHRs: 10 Things to Know,” February 16, 2015.
2 & 3 National Center for Biotechnology Information, “Electronic Health Records: Then, Now, and in the Future,” May 20, 2016.
4 The White House Archives, “Transforming Health Care: The President’s Health Information Technology Plan,” 2004.