A Brief History of EHRs

Timeline of electronic health record systems in US Hospitals

Maya Ber Lerner
2 min readOct 1, 2021

In most modern health systems, the clinicians’ digital experience is dominated by the Electronic Health Record system (EHR). Clinicians (i.e. health professionals that care for patients — including physicians, nurses, nurse practitioners, physician assistants and others) spend hours managing and documenting clinical processes on these systems. The resulting burnout has been a hot topic in the past years, but that deserves its own post :)

EHR systems (interchangeably called EMR — electronic medical record — systems) were introduced to the market over 50 years ago, but in the past decade they have become the de facto standard for managing patient medical records, which made them a primary source of digital health information, and a key player in healthcare digital transformation.

EHR systems were developed and used for a mix of purposes — from administrative (patient billing, scheduling), to clinical (patients’ medical information, communication between care providers, decision support) and medical research. They are used to manage and document a very wide variety of clinical processes and are therefore the most common clinician-facing software today.

Curious about the history of EHRs, and the technological and political forces that shaped their mainstream adoption? I was too. I did some research and even summarized it for you. Enjoy :)

The history of EHRs 1960–2021


Evans RS. Electronic Health Records: Then, Now, and in the Future. Yearb Med Inform. 2016;Suppl 1(Suppl 1):S48-S61. Published 2016 May 20. doi:10.15265/IYS-2016-s006 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5171496/

Development of the Electronic Health Record Virtual Mentor. 2011;13(3):186–189. doi: 10.1001/virtualmentor.2011.13.3.mhst1–1103. https://journalofethics.ama-assn.org/article/development-electronic-health-record/2011-03

Watzlaf VJ, Zeng X, Jarymowycz C, Firouzan PA. Standards for the content of the electronic health record. Perspect Health Inf Manag. 2004;1:1. Published 2004 Jan 7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2047330/

Adler-Milstein J, Holmgren AJ, Kralovec P, Worzala C, Searcy T, Patel V. Electronic health record adoption in US hospitals: the emergence of a digital “advanced use” divide. J Am Med Inform Assoc. 2017 Nov 1;24(6):1142–1148. doi: 10.1093/jamia/ocx080. PMID: 29016973; PMCID: PMC7651985. https://pubmed.ncbi.nlm.nih.gov/29016973/

Electronic Health Record Use at an All-Time High https://healthinformatics.uic.edu/blog/electronic-health-record-use-at-an-all-time-high/

The history of electronic health records (EHRs) https://www.elationhealth.com/blog/history-ehrs/

Cerner slips 2nd year but holds dominance alongside Epic for EHR market share https://www.beckershospitalreview.com/ehrs/cerner-slips-2nd-year-but-holds-dominance-alongside-epic-for-ehr-market-share.html

Federal Mandates for Healthcare: Digital Record-Keeping Requirements for Public and Private Healthcare Providers https://www.usfhealthonline.com/resources/healthcare/electronic-medical-records-mandate/