By Mary E. Morrison

CIOs wondering what practical innovation looks like up close may find inspiration in unexpected places — including their family physician's office or a local hospital's emergency room.

That's because healthcare CIOs around the world are hard at work making the vision of electronic health record (EHR) systems a reality. In theory, EHR systems offer significant efficiencies by providing quick access to clinical patient records, including radiology and lab results, past and current medications, allergies, and other treatments. These systems, once implemented, could then be linked into local or national exchanges, allowing medical professionals with appropriate access rights to see a patient's entire therapeutic history, regardless of where the patient has received care in the past.

The adoption of EHR and e-prescribing systems varies greatly between and within countries, according to a recent study from the Health Information Management and Systems Society ("Electronic Health Records, A Global Perspective"). The United Kingdom and New Zealand rank at the top, with 59 percent and 52 percent adoption, respectively. The U.S. rate, by comparison, is 17 percent.

While the challenges of EHR implementation vary by country, in the U.S., security concerns, a lack of standards and cost have been roadblocks. Even terminology can be a source of debate. Electronic medical records (EMRs) are considered by many to be a digital record of the care a patient receives in a particular setting, such as a hospital or doctor's office, while an EHR is a view of care received in multiple settings over a period of time. But the two terms are often used interchangeably.

Universally, one of the biggest challenges of adoption, says Lynne Dunbrack, Program Director at IDC Health Insights, is that many of the financial incentives for implementing electronic medical records (EMRs) accrue to payers — patients or insurance companies — not providers. EMRs make it easier, for example, for a medical provider to discover that a test he or she is about to perform has already been completed. He or she could then cancel the test, thereby eliminating a redundancy. "Somebody's cost savings is someone else's revenue," says Dunbrack.