Two decades ago, technological wave-determined healthcare IT, and fundamentally changed the role of CIOs. This wave—the advent of Electronic Health Records—brought with it a replacement paradigm, creating new CMIO positions also as an ever-growing team of analysts, managers, directors, and VPs to assist implement and support EHR systems. The assumptions of CIOs rapidly derived from the management of health information to directly supporting clinical transformation within health systems. Despite concerns associated with lack of interoperability, decreasing provider productivity, and suboptimal user experience, there has been an enormous investment in delivering EHR, with the $28 billion federal investment in health IT and therefore the passing of the HITECH Act being key to incentivizing adoption.
While EHR abilities has certainly improved, it fundamentally remains a transactional, provider-centric, record keeping system designed for the age of Fee-for-Service (FFS). Given soaring healthcare costs, significant variations in management, poor quality outcomes, and therefore the increasing fragmentation of care, healthcare is shifting towards pay-for-performance (P4P), the Merit-Based Incentive Payment System and Alternative Payment Models (APMs). This large-scale transformation towards value-based healthcare has unveiled an important limit to EHRs—that of enabling longitudinal care. the lack of EHRs to satisfy value-based requirements is, therefore, helping to shape a replacement technological wave of Health IT: The wave of patient-centered digital medicine technologies.
In 2003, the Institute of Drugs (IOM) settled on the name Electronic Health Record to assist direct the computerization of medical records towards improving the general safety and quality of look after patients; not just to exchange paper medical records. This, alongside FFS, shaped the EHRs we see today that was developed employing a plethora of disjointed lab information systems, billing systems, and result reviewing systems.