title: Electronic health record functionality needed to better support primary care.
abstract: Electronic health records (EHRs) must support primary care clinicians and patients, yet many clinicians remain dissatisfied with their system. This article presents a consensus statement about gaps in current EHR functionality and needed enhancements to support primary care. The Institute of Medicine primary care attributes were used to define needs and meaningful use (MU) objectives to define EHR functionality. Current objectives remain focused on disease rather than the whole person, ignoring factors such as personal risks, behaviors, family structure, and occupational and environmental influences. Primary care needs EHRs to move beyond documentation to interpreting and tracking information over time, as well as patient-partnering activities, support for team-based care, population-management tools that deliver care, and reduced documentation burden. While stage 3 MU's focus on outcomes is laudable, enhanced functionality is still needed, including EHR modifications, expanded use of patient portals, seamless integration with external applications, and advancement of national infrastructure and policies.
authors.affiliation: Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA.
authors.forename: Alex H
authors.initials: AH
authors.lastname: Krist
authors.affiliation: Department of Family Medicine and College of Industrial and Systems Engineering, University of Wisconsin, Madison, Wisconsin, USA.
authors.forename: John W
authors.initials: JW
authors.lastname: Beasley
authors.affiliation: Mathematica Policy Research, Princeton, New Jersey, USA.
authors.forename: Jesse C
authors.initials: JC
authors.lastname: Crosson
authors.affiliation: Center for Health IT, American Academy of Family Physicians, Kansas City, Kansas, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Kibbe
authors.affiliation: Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Klinkman
authors.affiliation: Departments of Pediatrics and Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Lehmann
authors.affiliation: Department of Family Medicine, University at Buffalo, Buffalo, New York, USA.
authors.forename: Chester H
authors.initials: CH
authors.lastname: Fox
authors.affiliation: Center for Health IT, American Academy of Family Physicians, Kansas City, Kansas, USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Mitchell
authors.affiliation: Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors.forename: James W
authors.initials: JW
authors.lastname: Mold
authors.affiliation: Department of Family Medicine, University of Colorado, Denver, Colorado, USA.
authors.forename: Wilson D
authors.initials: WD
authors.lastname: Pace
authors.affiliation: Department of Family Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Peterson
authors.affiliation: American Board of Family Medicine, Washington, District of Columbia, USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Phillips
authors.affiliation: Department of Family Medicine, Virtua Health, Voorhees, New Jersey, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Post
authors.affiliation: OCHIN, Portland, Oregon, USA.
authors.forename: Jon
authors.initials: J
authors.lastname: Puro
authors.affiliation: Department of Family Medicine, MetroHealth Medical Center, Cleveland, Ohio, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Raddock
authors.affiliation: Brookswood Family Practice, Langley, British Columbia, Canada.
authors.forename: Ray
authors.initials: R
authors.lastname: Simkus
authors.affiliation: Center for Health IT, American Academy of Family Physicians, Kansas City, Kansas, USA.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Waldren
mesh_terms: D032921:Consensus; D057286:Electronic Health Records / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D011320:Primary Health Care / Q000458:organization & administration*; D012955:Societies, Medical; D014481:United States
keywords: Electronic Health Records; Meaningful Use; Primary Care