| The Electronic Health Record (EHR) is now politically important. It has always, of course, been important to the discipline of Medical/Health Informatics and in many ways it has been the defining ‘Grand Challenge’ for its research. Many governments at this time, however, are taking an aggressive and positive response to the EHR as ‘solution’, and are actively promoting its rapid development, standardization, and utilization.
The EHR has been given the role of panacea; one which will not only solve the immediate and on-going problems of sub-standard care, but will also simultaneously cure the problems and expense associated with the means of its delivery. This ‘cure-all’ factor is driving governmental policy to implement the EHR as soon as possible. It is in many ways a political leap of faith with the expectation that all the anticipated benefits will be realized once “this so-called silver-bullet technology” is widely implemented.
Putting to one side for the moment the potential beneficial outcomes, it is a valid question to ask why there should be all the political interest now, particularly given that the EHR concept is not new. Indeed, the EHR is almost as old as the computers on which it depends. What then is it about the EHR that has successfully shifted the attention of the powerful to what is apparently merely a simple means of documenting health care and its associated processes in an electronic medium?
Furthermore, it is generally acknowledged that there is very little hard, specific evidence available to justify the grand claims being made on behalf of the EHR. Yet given the political imperative to implement, there would also seem to be no requirement for finding any new evidence as to whether or not the EHR path should be taken. It simply will be. The emphasis on implementation, however, poses serious questions as to what, if any, research is required with respect to the EHR and, perhaps more fundamentally, whether or not the discipline of Health Informatics has a future. |
