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Cited by 19Electronic Health Records SystemsNursing Diagnosis and DocumentationMedical Coding and Health Information

Meeting the challenges of electronic health record (EHR) optimization

Open access
Makhni, Sonya, Cerrato, Paul, Rico, Jose, Niazi, Shehzad, O’Horo, Jack, Peters, Steve, Shah, Vijay, Halamka, John·2025·npj Digital Medicine
DOI 10.1038/s41746-025-02178-wPMC PMC12769529
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Abstract

Electronic health records (EHRs) offer many potential benefits to clinicians in information accessibility, e-prescriptions, care coordination and more. Despite these benefits, most clinicians experience numerous shortcomings with EHRs that impact user satisfaction, efficiency, patient-physician relationships, and patient safety. With the widespread adoption of this technology already achieved, we must understand the shortcomings of EHRs to ensure these systems fulfill their intended purpose of improving patient care and clinical efficiency. Many systems inadequately incorporate user-friendly best practices and flexible architectures, limiting user control and customization. This review elaborates on usability, process, technology, and policy challenges. We also describe future solutions to mitigate these shortcomings and improve EHR functionality in clinical settings. Effective EHR improvement requires addressing known challenges through improved processes and technological innovation. Future EHR systems must be dynamic and adaptive, allowing seamless implementation of AI and related technologies across diverse clinical contexts and augmenting instead of impeding clinicians.

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  • Customization of the EHR is often not done by individual hospitals after their initial implementation of the EHR.

    “While theoretically some of these features are available through customization of the EHR, customization is often not done by individual hospitals after their initial implementation of the EHR. 31 32”

    From Qualitative Study of Inpatient Hospital Medicine Interruptive Alerts and Clinical Decision Support (2026) · cites this paper as [31]

    The User-centered design processes section says customization is lacking and that design and improvement processes are often not iterative. It does not specifically establish that individual hospitals often forgo EHR customization after initial implementation. (LLM, conf=0.81)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Makhni, S., Cerrato, P., Rico, J., Niazi, S., O’Horo, J., Peters, S., Shah, V., & Halamka, J.
Affiliations
  • Mayo Clinic (US)
  • Mayo Clinic in Florida (US)
Corresponding author
Makhni, Sonya
ORCID
Venue
npj Digital Medicine
Publisher
Springer Science and Business Media LLC
Published
2025-12-18
Volume
9
Issue
1
Pages
8-8
ISSN
2398-6352 (ISSN-L)
DOI
10.1038/s41746-025-02178-w
PMC
PMC12769529
OpenAlex
W4417461909
Cited by
19
References
9
Citations by year
2026: 19
FWCI
2.02
Type
journal article
Language
en
Open access
Licence
Locations
  • npj Digital Medicine (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Nursing › Issues, ethics and legal aspects › Nursing Diagnosis and Documentation
  • Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
Keywords
electronic health records, EHR usability, clinical workflow, patient safety, user control, care coordination, electronic prescribing

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