A Guide to Electronic Health Record Standards and the Challenges Ahead

Andrew Updegrove, Partner, Gesmer Updegrove LLP

2/06/2009
(Original Publish Date: 2/1/2009)

Since 2003, the United States has become increasingly committed to the deployment of comprehensive electronic health records (EHRs) for all Americans in order to dramatically decrease healthcare costs, reduce medical errors, and facilitate research. At the technical level, EHRs comprise multiple component specification frameworks intended to address identified "use cases," such as ordering lab tests, securely archiving the test results, and making the stored information available to authorized physicians, researchers and the patient into the future. Each component framework includes dozens of IT standards of many types. Since 2004, significant funding has been invested, and new administrative resources have been created, under the Department of Health and Human Services to facilitate progress towards developing and implementing EHRs nationwide by 2014. Concurrently, a diversity of private sector and private-public sector standards development initiatives have been actively engaged in developing the standards and related tools (e.g., implementation guidelines and certification tools) needed to enable EHRs. The Obama administration is today requesting, and Congress appears ready to provide, significant additional funding to deploy EHRs on a national basis. In this article, I review the history of EHR development and government activity to date, describe the many significant challenges to designing effective EHRs, survey the organizations developing EHRs, and finally recommend certain next steps needed to ensure that the national deployment of Electronic Health Records will be successful.