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Implications of an emerging EHR monoculture for hospitals and healthcare systems
Open accessAbstract
In many hospitals and health systems, a ‘new’ electronic health record means a shift to one vendor: Epic, a vendor that dominates in large and medium hospital markets and continues its success with smaller institutions and ambulatory practices. Our paper examines the implications of this emerging monoculture: its advantages and disadvantages for physicians and hospitals and its role in innovation, professional autonomy, implementation difficulties, workflow, flexibility, cost, data standards, interoperability, and interactions with other information technology (IT) systems.
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“While health care systems may influence the development of EHR features, there are concerns that the large market shares of relatively few EHR vendors may make vendors less responsive to designing EHRs to meet patients’ and clinicians’ needs, particularly while controlling costs and promoting interoperability [22].”
From Incorporating Social Determinants of Health in Electronic Health Records: Qualitative Study of Current Practices Among Top Vendors (2019) · cites this paper as [22]
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Research works printed but not linked: 3
- Bornstein, 2012, An integrated EHR at Northern California Kaiser Permanente: pitfalls, challenges, and benefits experienced in transitioning, Appl Clin Inform, 3, 318, 10.4338/ACI-2012-03-RA-0006 · DOI
- Koppel, 2013, Is healthcare information technology based on evidence?, Yearb Med Inform, 8, 7
- Smith, 2014, Healthcare information technology's relativity problems: a typology of how patients’ physical reality, clinicians’ mental models, and healthcare information technology differ, J Am Med Inform Assoc, 21, 117, 10.1136/amiajnl-2012-001419 · DOI
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Metadata
- Authors
- Koppel, R., & Lehmann, C. U.
- Affiliations
- University of Pennsylvania (US)
- Vanderbilt University (US)
- Venue
- Journal of the American Medical Informatics Association
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-10-23
- Volume
- 22
- Issue
- 2
- Pages
- 465-471
- ISSN
- 1067-5027 (ISSN-L)
- 1527-974X
- PMC
- PMC11749203
- OpenAlex
- W2155767215
- Cited by
- 140
- References
- 0
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 11 · 2023: 15 · 2022: 13 · 2021: 7 · 2020: 13 · 2019: 13 · 2018: 15 · 2017: 13 · 2016: 19 · 2015: 14
- FWCI
- 28.03
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Medical Informatics Association (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Science Foundation
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Keywords
- electronic health records, epic, market concentration, hospital information systems, interoperability, data standards, implementation barriers, physician workflow, professional autonomy
- MeSH terms
- Commerce, Delivery of Health Care, Health Facilities, Hospitals, United States, Medical Records Systems, Computerized, Systems Integration, Electronic Health Records
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