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J Am Med Inform Assoc. 2014 Sep-Oct;21(5):764-71. doi: 10.1136/amiajnl-2013-002229. Epub 2014 Jan 15.

Electronic health record functionality needed to better support primary care.

Author information

1
Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA.
2
Department of Family Medicine and College of Industrial and Systems Engineering, University of Wisconsin, Madison, Wisconsin, USA.
3
Mathematica Policy Research, Princeton, New Jersey, USA.
4
Center for Health IT, American Academy of Family Physicians, Kansas City, Kansas, USA.
5
Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA.
6
Departments of Pediatrics and Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, USA.
7
Department of Family Medicine, University at Buffalo, Buffalo, New York, USA.
8
Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
9
Department of Family Medicine, University of Colorado, Denver, Colorado, USA.
10
Department of Family Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
11
American Board of Family Medicine, Washington, District of Columbia, USA.
12
Department of Family Medicine, Virtua Health, Voorhees, New Jersey, USA.
13
OCHIN, Portland, Oregon, USA.
14
Department of Family Medicine, MetroHealth Medical Center, Cleveland, Ohio, USA.
15
Brookswood Family Practice, Langley, British Columbia, Canada.

Abstract

Electronic health records (EHRs) must support primary care clinicians and patients, yet many clinicians remain dissatisfied with their system. This article presents a consensus statement about gaps in current EHR functionality and needed enhancements to support primary care. The Institute of Medicine primary care attributes were used to define needs and meaningful use (MU) objectives to define EHR functionality. Current objectives remain focused on disease rather than the whole person, ignoring factors such as personal risks, behaviors, family structure, and occupational and environmental influences. Primary care needs EHRs to move beyond documentation to interpreting and tracking information over time, as well as patient-partnering activities, support for team-based care, population-management tools that deliver care, and reduced documentation burden. While stage 3 MU's focus on outcomes is laudable, enhanced functionality is still needed, including EHR modifications, expanded use of patient portals, seamless integration with external applications, and advancement of national infrastructure and policies.

KEYWORDS:

Electronic Health Records; Meaningful Use; Primary Care

PMID:
24431335
PMCID:
PMC4147605
DOI:
10.1136/amiajnl-2013-002229
[Indexed for MEDLINE]
Free PMC Article

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