Building Toward a Future for Electronic Health Record Systems

Health information technology tools, including electronic health records, are ubiquitous in healthcare across the United States. Despite the promise and opportunity of these tools, their benefits have been uneven while also having the unintended consequence of imposing substantial administrative and documentation challenges that are often linked to clinician burnout. The adoption of these tools has been shaped by financial incentives, regulatory programs, and sociotechnical demands tied to reimbursement and quality measurement. Patient-facing technologies, including patient portals and remote monitoring, expand access and engagement, but there are disparities in patient use and they often create burden for clinicians. Advances in artificial intelligence, and particularly large language models, now enable automated documentation, ambient capture of clinical encounters, and clinical decision support-offering potential to reduce clinician burden and enhance care delivery. We envision a future of health information technology in which these tools are fully embedded and integrated into the clinical environment such that they streamline clinical work and workflow, optimize decision-making, and improve patient engagement.