JMIR Publications

ABSTRACT

Background:

Electronic Health Records (EHRs) have revolutionized the accessibility and sharing of patient data among healthcare providers, fostering a more coordinated and efficient delivery of care. Over the past 25 years, the evolution of EHRs has significantly contributed to scientific achievements in healthcare, improving the accuracy and efficiency of patient care and supporting better health outcomes. Despite their numerous benefits, EHRs face challenges including interoperability issues, common data models, system compatibility, privacy concerns, and data cleaning complexities.

Objective:

The objective of our study was to examine the evolution of EHRs over the past 25 years, focusing on their advancements in technology, interoperability, and the impact on healthcare delivery and research. We aimed to identify the challenges and limitations of EHRs in facilitating disease management and understanding, as well as their contribution to epidemiological studies, pragmatic clinical trials, and health economic studies.

Methods:

We conducted a comprehensive review of literature from PubMed database pertaining to the development and implementation of EHRs over the past quarter-century. Studies from January 2000 to February 2024 were included. Finally, 1,377 studies were selected for the analysis and presentation.

Results:

Studies that utilized EHR data were for various research purposes, including epidemiological studies, clinical trials, cost-effective studies, and policy studies. We highlighted significant advancements in EHR technology that facilitated improved management and understanding of diseases through comprehensive data collection and analysis over the past 25 years. However, challenges related to data interoperability, privacy, and inconsistencies were also identified. The studies underscored the importance of EHRs in creating more accurate representations of clinical practices and patient populations. We also saw great efforts in incorporating data from different sources and formats with the EHRs, as well as new analytic tools and platforms.

Conclusions:

EHRs have emerged as a pivotal component of modern healthcare systems, enhancing the efficiency and accuracy of patient care and supporting advanced clinical research. Despite facing interoperability and data management challenges, the benefits of EHRs in improving healthcare delivery and facilitating significant scientific achievements are undeniable. To maximize their potential, there is a critical need for improved resource sharing, collaborations among healthcare providers, and the development of consistent data formats and policies in healthcare networks. Clinical Trial: NA