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Thieme E-Journals - Yearbook of Medical Informatics / Abstract

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// custom KV example window._adexc.push([ '/506/3014/', 'ut', '_kv', { 'IpLoggedIn':'false', 'LoggedIn':'false', 'isFulltext':'false', 'JournalDoi': '00034612', } ]); var axd = document.createElement('script'); axd.type = 'text/javascript'; axd.async = 1; axd.src = "https://dmp.theadex.com/d/506/3014/s/adex.js"; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(axd, s); })(); </script> <!-- TC-1735 MathML --> <script src="https://polyfill.io/v3/polyfill.min.js?features=es6"></script> <script type="text/javascript" id="MathJax-script" async src="https://cdn.jsdelivr.net/npm/mathjax@3/es5/mml-chtml.js"></script> <meta name="page" content="abstract"/> <meta name="layout" content="main"/> <meta name="prism:publicationName" content="Yearbook of Medical Informatics" /> <meta name="prism:issn" content="0943-4747" /> <meta name="prism:eissn" content="2364-0502" /> <meta name="prism:distributor" content="Georg Thieme Verlag KG" /> <meta name="prism:supplementStartingPage" content="S48" /> <meta name="prism:copyright" content="Georg Thieme Verlag KG Stuttgart" /> <meta name="prism:doi" content="10.15265/IYS-2016-s006" /> <meta name="prism:academicField" content="Original Article" /> <meta name="prism:person" content="R. S. Evans" /> <meta name="prism:publicationDate" content="2018/03/06" /> <meta name="prism:volume" content="25" /> <meta name="prism:issueIdentifier" content="S 01" /> <meta name="prism:startingPage" content="S48" /> <meta name="prism:endingPage" content="S61" /> <meta name="prism:keyword" content="Electronic Health Record" /> <meta name="prism:keyword" content="medical record" /> <meta name="prism:keyword" content="medical chart" /> <meta name="prism:url" content="http://www.thieme-connect.de/products/ejournals/html/10.15265/IYS-2016-s006" /> <meta name="citation_language" content="en" /> <meta name="citation_journal_title" content="Yearbook of Medical Informatics" /> <meta name="citation_journal_abbrev" content="Yearb Med Inform" /> <meta name="citation_issn" content="0943-4747" /> <meta name="citation_issn" content="2364-0502" /> <meta name="citation_publisher" content="Georg Thieme Verlag KG" /> <meta name="citation_doi" content="10.15265/IYS-2016-s006" /> <meta name="citation_title" content="Electronic Health Records: Then, Now, and in the Future" /> <meta name="citation_author" content="R. S. Evans" /> <meta name="citation_author_email" content="rscott.evans@imail.org" /> <meta name="citation_online_date" content="2018/03/06" /> <meta name="citation_publication_date" content="2016" /> <meta name="citation_volume" content="25" /> <meta name="citation_issue" content="S 01" /> <meta name="citation_firstpage" content="S48" /> <meta name="citation_lastpage" content="S61" /> <meta name="citation_fulltext_world_readable" content="" /> <meta name="citation_keyword" content="Electronic Health Record" /> <meta name="citation_keyword" content="medical record" /> <meta name="citation_keyword" content="medical chart" /> <meta name="citation_pdf_url" content="http://www.thieme-connect.de/products/ejournals/pdf/10.15265/IYS-2016-s006.pdf" /> <meta name="citation_fulltext_html_url" content="http://www.thieme-connect.de/products/ejournals/html/10.15265/IYS-2016-s006" /> <meta name="citation_xml_url" content="http://www.thieme-connect.de/products/ejournals/xml/10.15265/IYS-2016-s006.xml" format_fulltext="schema2.0" /> <meta name="citation_abstract_html_url" content="http://www.thieme-connect.de/DOI/DOI?10.15265/IYS-2016-s006" /> <meta name="citation_license" content="[null, null]" /> <meta name="citation_abstract" content="&lt;p&gt; &lt;b&gt;Objectives:&lt;/b&gt; Describe the state of Electronic Health Records (EHRs) in 1992 and their evolution by 2015 and where EHRs are expected to be in 25 years. Further to discuss the expectations for EHRs in 1992 and explore which of them were realized and what events accelerated or disrupted/derailed how EHRs evolved. Methods: Literature search based on “Electronic Health Record”, “Medical Record”, and “Medical Chart” using Medline, Google, Wikipedia Medical, and Cochrane Libraries resulted in an initial review of 2,356 abstracts and other information in papers and books. Additional papers and books were identified through the review of references cited in the initial review.&lt;/p&gt; &lt;p&gt; &lt;b&gt;Results:&lt;/b&gt; By 1992, hardware had become more affordable, powerful, and compact and the use of personal computers, local area networks, and the Internet provided faster and easier access to medical information. EHRs were initially developed and used at academic medical facilities but since most have been replaced by large vendor EHRs. While EHR use has increased and clinicians are being prepared to practice in an EHR-mediated world, technical issues have been overshadowed by procedural, professional, social, political, and especially ethical issues as well as the need for compliance with standards and information security. There have been enormous advancements that have taken place, but many of the early expectations for EHRs have not been realized and current EHRs still do not meet the needs of today’s rapidly changing healthcare environment.&lt;/p&gt; &lt;p&gt; &lt;b&gt;Conclusion:&lt;/b&gt; The current use of EHRs initiated by new technology would have been hard to foresee. Current and new EHR technology will help to provide international standards for interoperable applications that use health, social, economic, behavioral, and environmental data to communicate, interpret, and act intelligently upon complex healthcare information to foster precision medicine and a learning health system.&lt;/p&gt; " /> <meta name="citation_reference" content="citation_author=LL Weed; citation_publication_date=1971; citation_title=The problem oriented record as a basic tool in medical education, patient care and clinical research; citation_firstpage=131; citation_lastpage=4.; citation_journal_title=Ann Clin Res; citation_volume=3; " /> <meta name="citation_reference" content="citation_author=CJ McDonald; citation_author=R Murray; citation_author=D Jeris; citation_author=B Bhargava; citation_author=J Seeger; citation_author=L Blevins; citation_publication_date=1977; citation_title=A computer-based record and clinical monitoring system for ambulatory care; citation_firstpage=240; 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S. Evans" /> <meta name="dc:date" content="2018/03/06" /> <meta name="dc:accessRights" content="open-access" /> <meta name="dcterms:abstract" content=" Objectives: Describe the state of Electronic Health Records (EHRs) in 1992 and their evolution by 2015 and where EHRs are expected to be in 25 years. Further to discuss the expectations for EHRs in 1992 and explore which of them were realized and what events accelerated or disrupted/derailed how EHRs evolved. Methods: Literature search based on “Electronic Health Record”, “Medical Record”, and “Medical Chart” using Medline, Google, Wikipedia Medical, and Cochrane Libraries resulted in an initial review of 2,356 abstracts and other information in papers and books. Additional papers and books were identified through the review of references cited in the initial review. Results: By 1992, hardware had become more affordable, powerful, and compact and the use of personal computers, local area networks, and the Internet provided faster and easier access to medical information. EHRs were initially developed and used at academic medical facilities but since most have been replaced by large vendor EHRs. While EHR use has increased and clinicians are being prepared to practice in an EHR-mediated world, technical issues have been overshadowed by procedural, professional, social, political, and especially ethical issues as well as the need for compliance with standards and information security. There have been enormous advancements that have taken place, but many of the early expectations for EHRs have not been realized and current EHRs still do not meet the needs of today’s rapidly changing healthcare environment. Conclusion: The current use of EHRs initiated by new technology would have been hard to foresee. Current and new EHR technology will help to provide international standards for interoperable applications that use health, social, economic, behavioral, and environmental data to communicate, interpret, and act intelligently upon complex healthcare information to foster precision medicine and a learning health system. 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Future</h1> <span id="authorlist"><span class="author"> <div class="name">R. S. Evans</div> <div class="affiliation"> <sup>1 &thinsp; </sup>Intermountain Healthcare &amp; Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, USA</div> <div class="affiliation"></div> </span><a class="toggle-affiliation-infos" href="#">&rsaquo; Author Affiliations<span class="verbum"></span></a></span> <div class="toggleMenu articleToggleMenu"> <div class="toggleButton">Further Information<div class="toggleContent"> <div class="wrapper twoCols"> <div class="col"> <h3>Publication History</h3> <p> 20 May 2016<br> <br>Publication Date:<br>06 March 2018 (online)</p> </div> </div> </div> </div> <div class="platformLink"> <span class="label"><a style="color: #000000; text-decoration: none" class="virtualLink">Also available at</a></span><a target="_blank" class="btnPlatformLink" href="https://eref.thieme.de/10.15265/IYS-2016-s006"><img src="/media/10.1055-s-00000000/btn-eRef-desktop.png"></a> </div> </div> </div><ul class="tabBar borderBottom" id="articleTabs"> <li class="tab active"> <a href="#abstract">Abstract</a> </li> <li class="tab"> <a href="/products/ejournals/html/10.15265/IYS-2016-s006">Full Text</a> </li> <li class="tab"> <a href="#references">References</a> </li> </ul><div id="sections"> <section id="abstract"> <div class="articleFunctions">&nbsp;<input value="ai10.15265/IYS-2016-s006,10.15265/IYS-2016-s006" name="ai" type="hidden"> <div style="display: none" id="sfx10.15265/IYS-2016-s006"> <a id="sfxServer" data-href="?id=doi:10.15265/IYS-2016-s006&amp;sid=Thieme:Connect&amp;jtitle=Yearbook of Medical Informatics&amp;issue=S 01&amp;volume=25&amp;date=2016&amp;issn=0943-4747&amp;spage=S48&amp;epage=S61&amp;aulast=Evans&amp;aufirst=R. S.&amp;__char_set=utf8&amp;atitle=Electronic Health Records: Then, Now, and in the Future" target="sfx"><span class="articleAccessLabel sfx"><img id="sfxImageUrl" src="" alt="SFX Search" height="15" width="52"></span></a> </div>&nbsp;<a onClick="RightslinkPopUp(&quot;2364-0502&quot;, &quot;Electronic Health Records: Then, Now, and in the Future&quot;, &quot;03/06/2018&quot;, &quot;R. S. Evans&quot;, &quot;&quot;, &quot;10.15265/IYS-2016-s006&quot;, &quot;S48&quot;, &quot;S61&quot;, &quot;25&quot;, &quot;S 01&quot;, &quot;&quot;)" class="gotoLink" href="javascript:;">Permissions and Reprints</a> </div> <figure style="margin-left: 30px" class="floatRight"> <a data-doi="10.15265/IYS-2016-s006" data-caption="" data-id="10-15265-iys-2016-s006-1.jpg" data-cssClass="previewOverlay" href="https://www.thieme-connect.de/media/10.1055-s-00034612/2016S01/lookinside/10-15265-iys-2016-s006-1.jpg" class="zoomFunction alignLeft"><img src="https://www.thieme-connect.de/media/10.1055-s-00034612/2016S01/lookinside/thumbnails/10-15265-iys-2016-s006-1.jpg"></a> <figcaption></figcaption> </figure> <a name="N1064A"></a> <h3>Summary</h3> <p> <span style="" class="b">Objectives:</span> Describe the state of Electronic Health Records (EHRs) in 1992 and their evolution by 2015 and where EHRs are expected to be in 25 years. Further to discuss the expectations for EHRs in 1992 and explore which of them were realized and what events accelerated or disrupted/derailed how EHRs evolved. Methods: Literature search based on &ldquo;Electronic Health Record&rdquo;, &ldquo;Medical Record&rdquo;, and &ldquo;Medical Chart&rdquo; using Medline, Google, Wikipedia Medical, and Cochrane Libraries resulted in an initial review of 2,356 abstracts and other information in papers and books. Additional papers and books were identified through the review of references cited in the initial review.</p> <p> <span style="" class="b">Results:</span> By 1992, hardware had become more affordable, powerful, and compact and the use of personal computers, local area networks, and the Internet provided faster and easier access to medical information. EHRs were initially developed and used at academic medical facilities but since most have been replaced by large vendor EHRs. While EHR use has increased and clinicians are being prepared to practice in an EHR-mediated world, technical issues have been overshadowed by procedural, professional, social, political, and especially ethical issues as well as the need for compliance with standards and information security. There have been enormous advancements that have taken place, but many of the early expectations for EHRs have not been realized and current EHRs still do not meet the needs of today&rsquo;s rapidly changing healthcare environment.</p> <p> <span style="" class="b">Conclusion:</span> The current use of EHRs initiated by new technology would have been hard to foresee. Current and new EHR technology will help to provide international standards for interoperable applications that use health, social, economic, behavioral, and environmental data to communicate, interpret, and act intelligently upon complex healthcare information to foster precision medicine and a learning health system.</p> <i></i><i></i> <div class="articleKeywords"> <a name="N10663"></a> <h3>Keywords</h3> Electronic Health Record - medical record - medical chart </div> <div id="trendmd-suggestions"></div> </section> <section id="htmlfulltext">&nbsp;</section> <section id="references"> <a name=""></a> <ul class="literaturliste"> <a name="N1067F"></a> <li> <h3>References</h3> </li> <li> <a name="JRs006-1"></a><strong>1</strong> Weed LL. The problem oriented record as a basic tool in medical education, patient care and clinical research. 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} var inPageFacetsEndPoint = jsContextPath + "/" + inPageFacetsEndPoint; $(document).ready(function() { $('.hwgBoxOverlay').delay(5000).css({ width : screen.width + 'px', height : $(document).height() + 'px' }); const setCookie = function(cname, cvalue) { const d = new Date(); d.setTime(d.getTime() + ((21) * 24 * 60 * 60 * 1000)); // days to ms let expires = "expires=" + d.toUTCString(); document.cookie = cname + "=" + cvalue + ";" + expires + ";path=/"; } const getCookie = function(cname) { let name = cname + "="; let decodedCookie = decodeURIComponent(document.cookie); let ca = decodedCookie.split(';'); for(let i = 0; i <ca.length; i++) { let c = ca[i]; while (c.charAt(0) == ' ') { c = c.substring(1); } if (c.indexOf(name) == 0) { return c.substring(name.length, c.length); } } return ""; } let selectedFeedback = -1; // satisfactionPopup const buildFeedback = function() { const votes = 10; if (document.getElementById("feedbackBlock").innerHTML.length == 0) { for (let i = -1; i < votes; i++) { let newDiv = document.createElement("div"); newDiv.className = "feedback-value"; newDiv.innerHTML = i + 1; newDiv.setAttribute("data-value", i + 1); document.getElementById("feedbackBlock").appendChild(newDiv); } $("#hgwSubmit").val('true'); } }; const buildDoctorFeedback = function() { const options = [ 'Arzt', 'Pflegekraft', 'Therapeut', 'Hebamme', 'Student', 'SonstigesSelect' ]; const selectOptions = [ 'SonstigesSelect', 'Apotheker', 'Chemiker', 'Pharmaunternehmen', 'Assistenz', 'Fachangestellter', 'Rettungssanitaeter', 'Verwaltungsdienst', 'Wirtschaftsdienst', 'TechnischerDienst', 'Sonstiges' ]; if (document.getElementById("doctorFeedbackBlock").innerHTML.length == 0) { for (let i = 0; i < options.length; i++) { let parentDiv = document.createElement("div"); parentDiv.className = "doctorFeedbackElement"; let newDiv = document.createElement("input"); newDiv.className = "doctor-feedback-value"; newDiv.type = 'radio'; newDiv.name = 'doctorRadio'; if (options[i] == 'SonstigesSelect') { newDiv.value = ""; } else { newDiv.value = options[i]; } if (i == 0) { newDiv.checked = 'true'; } let newLabel = document.createElement("label"); if (i == 0) { newLabel.style = "font-weight: bold" } var text = "Physician"; if (options[i] == 'Pflegekraft') { text = "Health and care worker"; } else if (options[i] == 'Therapeut') { text = "Therapist"; } else if (options[i] == 'Hebamme') { text = "Midwife/delivery nurse"; } else if (options[i] == 'Student') { text = "Student (human medicine, dentistry, veterinary medicine)"; } else if (options[i] == 'SonstigesSelect') { text = "&nbsp;"; } newLabel.innerHTML = " " + text; parentDiv.appendChild(newDiv); parentDiv.appendChild(newLabel); let selectList = document.createElement("select"); selectList.id = "doctorSelect"; selectList.setAttribute("onfocus", "this.size=10;"); selectList.setAttribute("onblur", "this.size=0;"); selectList.setAttribute("onchange", "this.size=1; this.blur();"); //selectList.name = "doctorSelect"; if (options[i] == 'SonstigesSelect') { for (let j = 0; j < selectOptions.length; j++) { var option = document.createElement("option"); if (selectOptions[j] == 'SonstigesSelect') { option.value = ""; } else { option.value = selectOptions[j]; } //option.setAttribute("class", "b"); var text = "other, please select"; if (selectOptions[j] == 'Apotheker') { text = "Pharmacist"; } else if (selectOptions[j] == 'Chemiker') { text = "Chemist"; } else if (selectOptions[j] == 'Pharmaunternehmen') { text = "Employee of pharmaceutical company / wholesaler"; } else if (selectOptions[j] == 'Assistenz') { text = "Medical technical assistant"; } else if (selectOptions[j] == 'Fachangestellter') { text = "Med. Medical Assistant"; } else if (selectOptions[j] == 'Rettungssanitaeter') { text = "Paramedic"; } else if (selectOptions[j] == 'Verwaltungsdienst') { text = "Administrative service in hospital"; } else if (selectOptions[j] == 'Wirtschaftsdienst') { text = "Economic and supply service in the hospital"; } else if (selectOptions[j] == 'TechnischerDienst') { text = "Technical service in the hospital"; } else if (selectOptions[j] == 'Sonstiges') { text = "Other"; } option.text = text; selectList.appendChild(option); } } if (selectList.length > 0) { parentDiv.appendChild(selectList); } document.getElementById("doctorFeedbackBlock").appendChild(parentDiv); } } }; $('#doctorFeedbackBlock').on('click', '.doctor-feedback-value', function() { var job = $('input[name="doctorRadio"]:checked').val(); if (job !== undefined && job.length > 0) { $('#doctorSelect').val(''); } }); //$('#doctorFeedbackBlock').on('change', '.doctorFeedbackElement', function() { // $('input[name="doctorRadio"]').filter('[value=""]').prop('checked', true); //}); $('#doctorFeedbackBlock').on('click', '.doctorFeedbackElement', function() { $(this).find('input').prop('checked', true); $('#doctorFeedbackBlock').find('label').removeAttr('style'); $(this).find('label').attr('style', 'font-weight: bold'); var job = $('input[name="doctorRadio"]:checked').val(); if (job !== undefined && job.length > 0) { $('#doctorSelect').val(''); $('#doctorSelect').removeClass("b"); $('#doctorSelect').find('option').removeAttr('class'); } }); $('#doctorFeedbackBlock').on('focus', '.doctorFeedbackElement', function() { $('#doctorSelect').val(''); }); $('#doctorFeedbackBlock').on('blur', '#doctorSelect', function() { $('#doctorSelect').addClass("b"); for (var i = 0; i < this.length; i++) { if (this.value == this.options[i].value) { this.options[i].setAttribute("class", "bold"); } else { this.options[i].setAttribute("class", "normal"); } } }); $('#feedbackBlock').on('click', '.feedback-value', function() { const that = this; $(".feedback-value").each(function(index, element) { element.className = "feedback-value"; }); that.className += " feedback-selected" selectedFeedback = parseInt(this.getAttribute('data-value')); }); $("#hwgOk").click(function() { var hwgSubmit = $("#hgwSubmit").val(); // Feedback "Zufriedenheit" if (hwgSubmit === 'true') { if (selectedFeedback >= 0 && selectedFeedback < 11) { $("#hgwSubmit").val('false'); // send request const begrundung = $("#begrundung").val(); const url = '/products/json/addHwgValue?value=' + selectedFeedback + '&text=' + begrundung; const request = $.ajax({ type : 'GET', async : true, cache: false, url, success : function(data) { // close popup setCookie('hwg_value', false); $('#hwg-popover').css('display', 'none'); $("#begrundung").val(""); } }); } } }); $("#hwgCloseLink").click(function() { var hwgSubmit = $("#hgwSubmit").val(); $("#hgwSubmit").val('false'); if (hwgSubmit === 'true') { // send request const url = '/products/json/addHwgValue?value=keine Angabe&text='; const request = $.ajax({ type : 'GET', async : true, cache: false, url, success : function(data) { // close popup setCookie('hwg_value', false); $('#hwg-popover').css('display', 'none'); $("#begrundung").val(""); } }); } }); $("#hwgDoctorOk").click(function() { // send request var job = $('input[name="doctorRadio"]:checked').val() if (job == undefined || job.length == 0) { job = $('#doctorSelect').val(); } if (job !== undefined && job.length > 0) { //if($('input[name="doctorRadio"]:checked').val() === "Sonstiges") { if(job === "Arzt" || $('#doctorSelect').val() === "Apotheker" || $('#doctorSelect').val() === "Pharmaunternehmen") { setCookie('hwg_job_value', true); } else { setCookie('hwg_job_value', false); } $('#hwg-popover').css('display', 'none'); // TC-2224: Store profession const url = '/products/json/addHwgValue?value=profession&text=' + job; const request = $.ajax({ type : 'GET', async : true, cache: false, url, success : function(data) { // close popup $('#hwg-popover').css('display', 'none'); $("#begrundung").val(""); } }); } window.location.reload(); }); $("#doctorCloseLink").click(function() { // send request setCookie('hwg_job_value', false); $('#hwg-popover').css('display', 'none'); }); $("#currentYearCopyright").text(new Date().getFullYear()); }); $(function(){ $('.selectList.dropMenu>li>a').click(function(e){ e.preventDefault(); var selectedId = $(this).attr('id'); $('#navSearchRadius').val(selectedId); $(this).closest('form').submit(); }); }); function open_fg(url, id) { fgwindow = window.open(url, id); fgwindow.focus(); } function showElement(div) { with(document.getElementById(div).style){ if(display == "none"){ display = "inline"; } else { display = "none"; } } } function openImage(content) { var myWindow = window.open("", "newWindow", "width=600,height=300,left=100,top=200,scrollbars=1"); myWindow.document.write('<img src="' + content + '"/>'); myWindow.document.close(); myWindow.focus(); } //Gets the parameters from a URL function getUrlParam(name){ name = name.replace(/[\[]/, "\\\[").replace(/[\]]/, "\\\]"); var regexS = "[\\?&]" + name + "=([^&#]*)"; var regex = new RegExp(regexS); var results = regex.exec(window.location.hash); 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