EHR and Real-World Data: A Brief History

Before delving into the history of Electronic Health Records (EHR), let’s see what an Electronic Health Record (EHR) is? 

According to the organization HealthIT.org, “An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users. While an EHR does contain patients' medical and treatment histories, an EHR system is built to go beyond standard clinical data collected in a provider’s office and can be inclusive of a broader view of a patient’s care. EHRs are a vital part of health IT and can:

• Contain a patient’s medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results
• Allow access to evidence-based tools that providers can use to make decisions about a patient’s care
• Automate and streamline provider workflow”

EHR advancement is a story of technological evolution, policy development, and the pursuit of improved healthcare delivery. From its humble beginnings over fifty years ago to the sophisticated systems in use today, the journey of EHR data represents a significant shift in the way health information is managed and utilized.

The Early Years

The earliest attempts at digitizing health records in the 1960s and 70s were driven by visionary healthcare professionals and technologists who saw the potential for computers to revolutionize patient care. These initial systems, however, were limited by the technology of the time and were primarily used for administrative functions rather than clinical purposes.

Emergence of Pioneers: Cerner, Epic, and Meditech

Three companies that played pivotal roles in advancing EHR technology were Cerner, Epic, and Meditech. Each brought unique innovations and helped shape the industry landscape.

Meditech is one of the earliest entrants into the EHR space, founded in 1969 by Neil Pappalardo. The company made its mark by focusing on providing affordable healthcare information systems. Over the decades, Meditech has continued to evolve, offering solutions that support acute, ambulatory, and specialty care. Meditech's longevity in the market is a testament to its ability to adapt and innovate in response to changing healthcare needs.

Cerner was founded in 1979 by Neal Patterson, Paul Gorup, and Cliff Illig, with a vision to digitize paper health records. Cerner's early focus on developing software to automate clinical lab work soon expanded, laying the groundwork for their integrated EHR solutions. Over the years, Cerner Millennium, their flagship offering, has grown to support a wide array of healthcare functionalities beyond labs, including pharmacy, radiology, and patient care.

Epic, founded by Judith Faulkner in 1979, started in a basement in Madison, Wisconsin. Faulkner's goal was to create a database that could be used by multiple applications without data being siloed. Epic's commitment to a single, unified patient record accessible across all care areas has been a hallmark of its success. Today, Epic's systems are used by some of the world's largest and most prestigious healthcare organizations.

Government Involvement and Acceleration

The transformational moment for EHR adoption came with significant government involvement in the 2000s. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 was particularly pivotal, offering financial incentives for the adoption and meaningful use of EHR systems. This led to a surge in EHR implementation across the United States.

Challenges and Looking ahead

Despite the benefits, the journey of EHR implementation has been challenging. Issues such as interoperability, usability, and the substantial costs associated with EHR systems have been points of contention. Furthermore, patient privacy and data security concerns continue to be hot topics.

Today, EHR systems are integral to healthcare delivery. The focus is now shifting towards leveraging the vast amounts of data EHRs collect to improve patient outcomes through predictive analytics, personalized medicine, and public health initiatives. Interoperability remains a key challenge, with efforts underway to create a truly connected health ecosystem where data can flow seamlessly between providers, payers, and patients.

The history of EHR data reflects the broader healthcare industry’s journey towards embracing technology to serve patients better. As companies like Cerner, Epic, and Meditech continue to innovate, the future of healthcare IT looks promising, with the potential to transform patient care in ways that were unimaginable when this journey first began.