Integrating electronic health records in the physical environment: a systems approach

Electronic health records (EHRs) are the future of the healthcare industry; however, insufficient attention is paid to where and how the hardware systems that support EHR software are integrated in the existing environment.The physical implementation of EHRs is an underlying component of the technology program that may pose barriers and/or gateways to EHR adoption in terms of patient safety and satisfaction, clinical usability of the EHR system, cultural acceptance, and organizational workflow. After confirming that environmental interventions are most effective when coupled with cultural programs, this article asserts that hardware is a necessary complement to EHR software implementation if usage is to progress strategically and ergonomically. This article then seeks to explain how, based on evidence-based design (EBD) decisions, the built environment that supports EHR software can enhance or hinder communication. The findings of this paper posit that when EHR hardware is designed ergonomically and with provider-patient communication at the forefront of point-of-care services, EHR usage in the healthcare environment can improve the quality of health services delivery.This article is the result of a literature review, case studies, academic lectures, healthcare informatics webinars, and discussions with architects, interior design professionals, and corporate EHR leaders.