What Makes an EHR?
August 18, 2025
Write Up
As usual with a side project, we will see where this takes me. I'm starting with grand ideas but ya know... time. My focus here will be generating an EHR. Not an easy realistic challenge to solve but one I've often toyed with. A former coworker of mine got sick of me constantly saying what we could build that he told me to just go build one then and shut up.
As much as I'd like to, I'm going to do the responsible thing and not jump right into writing code. This is the temptation and fun thing to do for software developers but for this case I'm going to look over some old notes I've had and dive into what I'd like to build.
First, I'll lay out the components of an EHR in this month's post. Next month I'd like to dive into the actual design of the architecture I'd like to attempt to build. Finally, I'll focus in on the personas of individual workflows that I'd like the product to solve. My brain is thinking (likely a terrible thought) that it'll have a main core / engine with different modules but remembering my days at Meditech I want these modules to be as much of a thin UI layer as possible and easily switched out. UI / UX is one of my main weaknesses and it's often the biggest complaint of EHRs that leads to burnout so I don't want this product to rely on my off the cuff non-customer discussed workflows.
One side note - I use Github copilot when coding but when writing I turn it off. I found myself too often starting to write and then github copilots guesses at what I want to write too often lead my train of thought. It's an interesting thing that a future post could be about if I ever wrap my brian around it. I know there's tons of those posts out there already written by people much smarter and more focused on that problem where the AI leads the Brain and not the other way around.
Components
Patient Registration and Check-In
- Capturing patient demographics, insurance information, and consent forms.
- Assigning unique identifiers for accurate record-keeping.
Clinical Documentation
- Recording patient encounters, medical history, symptoms, diagnoses, and treatment plans.
- Ensuring compliance with regulatory standards (e.g., HIPAA).
Order Entry and Results Management
- Physicians can electronically order tests, medications, and procedures.
- Tracking and managing lab results, radiology reports, and other diagnostic findings.
Medication Management
- E-prescribing medications, including dosage instructions and potential interactions.
- Monitoring medication adherence and adverse reactions.
Clinical Decision Support
- Providing alerts for drug allergies, potential interactions, and evidence-based guidelines.
- Assisting clinicians in making informed decisions during patient care.
Billing and Coding
- Generating accurate billing codes for services rendered.
- Facilitating reimbursement and financial management.
Interoperability and Health Information Exchange (HIE)
- Enabling seamless data exchange between different healthcare providers and systems.
- Supporting continuity of care across settings (e.g., hospitals, clinics, and pharmacies).
Appointment Scheduling and Reminders
- Managing patient appointments, cancellations, and rescheduling.
- Sending automated reminders to patients.
Care Coordination and Referrals
- Facilitating communication among care team members (physicians, nurses, specialists).
- Referring patients to specialists or other services.
Quality Reporting and Population Health Management
- Collecting data for quality improvement initiatives.
- Identifying trends, gaps in care, and opportunities for preventive measures.
Personas To Focus on Initially
Dr. Emily, the Attentive Physician
- Role: Primary care physician
- Persona: Dr. Emily is a seasoned physician who values thorough documentation. She relies on the EHR to review patient histories, order tests, and make informed decisions. She appreciates clinical decision support alerts and ensures patient safety.
Nurse Alex, the Compassionate Caregiver
- Role: Registered nurse
- Persona: Nurse Alex is dedicated to patient well-being. In the EHR, Alex records vital signs, administers medications, and communicates with other team members. Alex’s empathy shines during patient interactions.
Dr. Marcus, the Researcher and Innovator
- Role: Specialist (e.g., cardiologist, oncologist)
- Persona: Dr. Marcus thrives on evidence-based medicine. He uses the EHR to track treatment outcomes, participate in clinical trials, and contribute to medical research. Marcus seeks efficiency without compromising quality.
Admin Assistant Lisa, the Organizational Wizard
- Role: Front desk staff
- Persona: Lisa manages appointments, handles patient check-ins, and ensures smooth clinic operations. She appreciates EHR features for scheduling, reminders, and patient communication.
Pharmacist Ryan, the Medication Guru
- Role: Pharmacist
- Persona: Ryan reviews medication orders, checks for interactions, and educates patients. The EHR helps Ryan track prescriptions, dosages, and refill requests. Ryan’s attention to detail prevents medication errors.
IT Specialist Jordan, the Tech Enthusiast
- Role: Health IT professional
- Persona: Jordan maintains EHR systems, troubleshoots issues, and ensures data security. Eager to explore new features, Jordan collaborates with clinicians to optimize workflows.
Patient Sarah, the Engaged Advocate
- Role: Patient
- Persona: Sarah accesses her health records through the patient portal. She appreciates EHRs for appointment reminders, lab results, and secure messaging. Sarah actively participates in her care decisions.
Doctor Colleen, the Surgeon
- Role: tbd
- Persona: tbd
Kevin, Surgeon Assistant
- Role: tbd
- Persona: tbd