Electronic Health Records: Design, Implementation, and Policy for Higher-Value Primary Care
Authors: Christine A. Sinsky, John W. Beasley, Greg E. Simmons, Richard J. Baron
Journal: Annals of Internal Medicine (2014)

Ideas and Opinions20 May 2014Electronic Health Records: Design, Implementation, and Policy for Higher-Value Primary CareChristine A. Sinsky, MD, John W. Beasley, MD, Greg E. Simmons, MA, and Richard J. Baron, MDChristine A. Sinsky, MDFrom Medical Associates Clinic and Health Plans, Dubuque, Iowa; University of Wisconsin School of Medicine and Public Health and MetaStar, Madison, Wisconsin; and American Board of Internal Medicine and ABIM Foundation, Philadelphia, Pennsylvania., John W. Beasley, MDFrom Medical Associates Clinic and Health Plans, Dubuque, Iowa; University of Wisconsin School of Medicine and Public Health and MetaStar, Madison, Wisconsin; and American Board of Internal Medicine and ABIM Foundation, Philadelphia, Pennsylvania., Greg E. Simmons, MAFrom Medical Associates Clinic and Health Plans, Dubuque, Iowa; University of Wisconsin School of Medicine and Public Health and MetaStar, Madison, Wisconsin; and American Board of Internal Medicine and ABIM Foundation, Philadelphia, Pennsylvania., and Richard J. Baron, MDFrom Medical Associates Clinic and Health Plans, Dubuque, Iowa; University of Wisconsin School of Medicine and Public Health and MetaStar, Madison, Wisconsin; and American Board of Internal Medicine and ABIM Foundation, Philadelphia, Pennsylvania.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M13-2589 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Electronic health records (EHRs), and the policies and workflows around them, are inconsistently aligned with the needs of primary care patients and physicians. This results in substantial waste of physician and support resources, high rates of burnout (1, 2), and a decrease in primary care capacity precisely at the time when our nation needs a stronger primary care foundation (3).We propose a set of principles (Table) directed toward vendors, institutional leaders, policymakers, and physicians to support higher-value primary care. These principles draw on our expertise in patient care, quality assurance, industrial and systems engineering, and policy and EHR implementation. ...References1. Babbott S, Manwell LB, Brown R, Montague E, Williams E, Schwartz M, et al. Electronic medical records and physician stress in primary care: results from the MEMO Study. J Am Med Inform Assoc. 2014;21:e100-6. [PMID: 24005796] CrossrefMedlineGoogle Scholar2. Friedberg MW, Chen PG, Van Busum KR, Aunon FM, Pham C, Caloyeras JP, et al. 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Br J Gen Pract. 2011;61:604-5. [PMID: 22152827] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Christine A. Sinsky, MD; John W. Beasley, MD; Greg E. Simmons, MA; Richard J. Baron, MDAffiliations: From Medical Associates Clinic and Health Plans, Dubuque, Iowa; University of Wisconsin School of Medicine and Public Health and MetaStar, Madison, Wisconsin; and American Board of Internal Medicine and ABIM Foundation, Philadelphia, Pennsylvania.Disclaimer: Drs. Sinsky and Beasley and Mr. Simmons are members of the National Collaborative for Improving Primary Care Through Industrial and Systems Engineering (I-PrACTISE), but their views do not represent any formal policy statement from I-PrACTISE. Dr. Baron is CEO at the American Board of Internal Medicine (ABIM), but the views expressed here are not those of the ABIM.Disclosures: None. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-2589.Corresponding Author: Christine A. Sinsky, MD, Medical Associates Clinic and Health Plans, Department of Internal Medicine, 1000 Langworthy Street, Dubuque, IA 52002; e-mail, [email protected]com.Current Author Addresses: Dr. Sinsky: Medical Associates Clinic and Health Plans, Department of Internal Medicine, 1000 Langworthy Street, Dubuque, IA 52001.Dr. Beasley: University of Wisconsin School of Medicine and Public Health, Departments of Family Medicine and Industrial and Systems Engineering, 1100 Delaplaine Court, Madison, WI 53715.Mr. Simmons: MetaStar, 2909 Landmark Place, Madison, WI 53713.Dr. Baron: American Board of Internal Medicine and ABIM Foundation, 510 Walnut Street, Suite 1700, Philadelphia, PA 19106.Author Contributions: Conception and design: C.A. Sinsky, J.W. Beasley, G.E. Simmons.Analysis and interpretation of the data: J.W. Beasley.Drafting of the article: C.A. Sinsky, J.W. Beasley, G.E. Simmons, R.J. Baron.Critical revision of the article for important intellectual content: C.A. Sinsky, J.W. Beasley, G.E. Simmons.Final approval of the article: C.A. Sinsky, J.W. Beasley, G.E. Simmons.Administrative, technical, or logistic support: J.W. Beasley, G.E. Simmons.Collection and assembly of data: J.W. Beasley. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoElectronic Health Records Michael E. Miller Electronic Health Records Alan W. Feld Electronic Health Records John W. Beasley and Christine A. Sinsky Electronic Health Records John W. Beasley and Christine A. Sinsky Electronic Health Records Alan W. Feld Electronic Health Records Michael E. 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Miller, MDElectronic Health RecordsAlan W. Feld, MD 20 May 2014Volume 160, Issue 10Page: 727-728KeywordsDecision makingDisclosureElectronic medical recordsHealth careHealth care providersHealth care quality assessmentHealth information technologyPatientsPrevention, policy, and public healthSafety ePublished: 20 May 2014 Issue Published: 20 May 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...