When did EHRs begin?

The electronic health record (EHR) dates to the 1960s, when computer systems were first being developed and honed for practical use. Paper medical files continued to be used for some time (and are actually still being used in some medical practices today), but the computer revolution added significantly to the evolution of the medical record. So when was the EHR first implemented?

The earliest known predecessor to today’s EHR was the Problem-Oriented Medical Record (POMR) developed by Dr. Lawrence Weed “so that medical students and practitioners could function in a structured, rigorous way more like that of workers in the scientific community.”

As noted by the American Health Information Management Association (AHIMA), “From the moment technological advances moved data entry from punch cards to keyboards, and data display from printed results to video display terminals, innovative physician tinkerers around the country have seized on the opportunity to improve healthcare delivery.”

The AHIMA, in its HIM Body of Knowledge, identifies several of the earliest efforts to implement EHRs, known by various names in the 1960s and 1970s, including electronic medical records, computerized medical records, longitudinal patient records, and electronic charts. Those “more well-known efforts include:

• Lockheed Corporation, in 1971, created a system for El Camino Hospital, featuring computerized physician order entry (CPOE) and allowing multiple, simultaneous users.
• In the early 1970s, the University of Utah, 3M, and Latter Day Saints Hospital deployed the Health Evaluation through Logical Processing system.
• Researchers at Massachusetts General Hospital launched the Computer Stored Ambulatory Record project in 1968, which had modular design and accommodated flexible clinical vocabularies through vocabulary mapping.
• The Regenstrief Institute in Indianapolis created the Regenstrief Medical Record System in 1972, incorporating then nascent object-oriented programming principles to automate integration of structured, electronic clinical data from their sources, such as laboratories and pharmacies.
• The Veterans Administration (now known as the Department of Veterans’ Affairs) began work on the Decentralized Hospital Computer Program, the progenitor of the Veterans Health Information Systems and Technology Architecture, which innovated an enterprise-wide EHR system spanning hundreds of clinical settings across the country.”