The evolution of EHR-S functionality for care and coordination

The purpose of electronic health record systems (EHR-S) functionalities is to improve patient safety by reducing medical errors that lead to harm and to facilitate the measurement of care quality by providing access to process and outcomes data. Through collaborative standards development, the definition and translation of healthcare work into specific system functionalities for improving clinical data capture, communication and coordination has evolved from technical "wish lists" into commercially available products that meet the needs of multiple stakeholders: patients, clinicians, managers, systems developers, payers and regulatory agencies. Important technical drivers in the development and adoption of EHR-S functionalities have been: (a) progressive regulatory requirements for reporting quality measures and (b) lessons learned from deployment of EHR systems and other health information technology. A growing area of attention and challenge for health IT functionality development is in supporting longitudinal care coordination for patients with complex and chronic disease across time, providers and resources. Work in this domain has focused on (a) aligning and connecting Patient Centered Medical Homes and Medical Neighborhoods via data/communication standards to facilitate health information exchange (HIE) and (b) building the information infrastructures to facilitate the collection and reporting of quality measures related to care processes and outcomes.