A Brief History of EHRs

Timeline of electronic health record systems in US Hospitals

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/

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