Reconceptualizing the Electronic Health Record for a New Decade: A Caring Technology?

• Published in: Advances in nursing science Vol. Publish Ahead of Print; no. 3; pp. 193 - 205
• Main Authors: Robichaux, Catherine, Tietze, Mari, Stokes, Felicia, McBride, Susan
• Format: Journal Article
• Language: English
• Published: United States Copyright Wolters Kluwer Health, Inc. All rights reserved 01-07-2019; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Clinical outcomes; Decision support systems; Electronic health records; Information technology; Nursing; Telemedicine
• ISSN: 0161-9268; 1550-5014
• DOI: 10.1097/ANS.0000000000000282

Since the 2009 publication by Petrovskaya et al on, “Dilemmas, Tetralemmas, Reimagining the Electronic Health Record,” and passage of the Health Information Technology for Economic Clinical Health (HITECH) Act, 96% of hospitals and 78% of providers have implemented the electronic health record. While many positive outcomes such as guidelines-based clinical decision support and patient portals have been realized, we explore recent issues in addition to those continuing problems identified by Petrovskaya et al that threaten patient safety and integrity of the profession. To address these challenges, we integrate polarity thinking with the tetralemma model discussed by Petrovskaya et al and propose application of a virtue ethics framework focused on cultivation of technomoral wisdom.