Essential Electronic Health Record Reforms for This Decade

JAMA Network May 4, 2023
By Don Eugene Detmer, MD, MA; Andrew Gettinger, MD

Few health care innovations have been more intrusive and ubiquitous than electronic health records (EHRs). Despite EHRs’ distinct advantages, the structure of health care services in the US has made it difficult to exploit their most desirable features. Instead of supporting clinicians seeking to deliver care more effectively and efficiently, current EHR design and configurations attempt to manage clinicians and how they do their work. The deterioration in the patient-clinician relationship and increased clinician burden are often blamed on the EHR. Meanwhile, the financial and administrative requirements that are implemented via EHRs have been ignored.

Like tackling the problems of climate change, partisan-divided government, and global infectious disease prevention, reforming EHRs can be qualified as a “wicked problem,” in the...

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