The Evolution of Electronic Health Records


Conventional health records were written on paper and stored in folders, which were kept based on a predetermined filing system. The advancement of computer technology in the 1960s laid the foundation for the creation of electronic health records (EHRs), which have revolutionized the healthcare system (Evans, 2016). In this discussion, I explain two design capabilities of EHRs and how they would enhance the system. I also explain an EHR issue that I have experienced or encountered and how it was addressed.

Increased Use of Cloud Technology

Cloud technology is the use of hardware and software to provide services through a network (Rodrigues, De La Torre, Fernández, & López-Coronado, 2013). The most commonly used network is the Internet. Data in cloud technology is kept in numerous physical and virtual servers that are held by a third-party service provider. The most common benefit of cloud technology is that data can be retrieved from any device provided there is a reliable Internet connection.

Cloud technology would improve EHRs by lowering the cost of installation and eliminating the need to set up client-server systems. Cloud technology would also reduce infrastructure and information technology costs. Cloud computing facilitates real-time access to patient data from several locations. For example, patient data can be retrieved from different devices such as tablets, desktop computers or laptops simultaneously. This enhanced accessibility is particularly useful to patients who receive health care services from multiple providers. Cloud-based servers also confer flexibility to clinicians by allowing them to work outside their offices.

Domain Knowledge to Identify Relevant Parts of the Record to Display

The presentation of a patient’s records can influence the physician’s ability to interpret the information. Domain knowledge is an algorithm that recognizes pertinent sections of the record to display to the user to fulfill the information requirements of each user. Showing large volumes of irrelevant data causes information overload and hampers the processing and interpretation of the information. Current EHR systems are characterized by scattering of results and interpretations data across different parts of the user interface, which compels the user to navigate through numerous screens to find relevant information. This layout wastes precious time that could be used to attend to patients.

Developing EHR systems with domain knowledge would improve EHRs by enhancing the information retrieval process and save time. Additionally, information overload could cause a mix-up in data interpretation and introduce medical errors. Therefore, an EHR system with domain knowledge would eliminate chances of such medical errors.

EHR Problem and How it was Solved

One issue that I have encountered with the use of EHRs is associated with domain knowledge of EHRs. The use of electronic health records is governed by privacy and confidentiality laws (Fernández-Alemán, Señor, Lozoya, & Toval, 2013). In a newly implemented EHR system within a primary care facility, anybody with access to the system could access all sections of patient records. Consequently, there were issues with disclosure of sensitive patient information to other clinic workers who had access to the system. However, this problem was solved by limiting the amount of information that could be accessed by different healthcare workers. Sections containing sensitive patient data were password-protected and accessible to the clinician only. This move ensured that the privacy and confidentiality of patient data were upheld.


EHRs have revolutionized healthcare by improving the storage and access of patient data. The flexibility of EHRs permits the incorporation of various design capabilities, which can improve the overall efficiency of the system. Therefore, there is a need to be conversant with the benefits and shortcoming of each design capability.


Evans, R. S. (2016). Electronic health records: Then, now, and in the future. IMIA Yearbook of Medical Informatics, 2016, 1-14. Web.

Fernández-Alemán, J. L., Señor, I. C., Lozoya, P. Á. O., & Toval, A. (2013). Security and privacy in electronic health records: A systematic literature review. Journal of Biomedical Informatics, 46(3), 541-562.

Rodrigues, J. J., De La Torre, I., Fernández, G., & López-Coronado, M. (2013). Analysis of the security and privacy requirements of cloud-based electronic health records systems. Journal of Medical Internet Research, 15(8), e186.

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