Commercial electronic health records (EHRs) were first developed to automate business processes. As EHRs developed, design principles focused on transferring existing paper-based documentation to comparable electronic forms. In addition, a strong industry focus on adult healthcare settings and quality measures has limited attention and resources for high priority EHR functionality needed for the unique health care of children. The objective of this paper is to provide a review of innovation in the EHR, that includes a variety of established and emerging technologies that may help realize a more effective EHR in child health settings. A more effective EHR would serve as an electronic hub. Existing EHR infrastructure could provide the foundation upon which new technologies and approaches branch and extend, enabling more rapid and customizable innovation to better meet shifting stakeholder and end-user needs. Among many areas for improvement, key goals of innovation could include technology that relieves ambulatory primary care clinician documentation burden, identifies needs, and supports improved care coordination and outcomes, focused on the following key areas: identification of child and family care needs, decision support, documentation, care coordination, and family communication.

商业电子健康记录 (EHR) 最初是为了自动化业务流程而开发的。随着 EHR 的发展，设计原则侧重于将现有的纸质文档转换为可比较的电子表格。此外，行业对成人医疗保健环境和质量措施的强烈关注限制了对儿童独特医疗保健所需的高优先级 EHR 功能的关注和资源。本文的目的是对 EHR 的创新进行回顾，其中包括各种可能有助于在儿童健康环境中实现更有效的 EHR 的成熟和新兴技术。更有效的 EHR 将充当电子中心。现有的 EHR 基础设施可以为新技术和方法的分支和扩展提供基础，实现更快速和可定制的创新，以更好地满足不断变化的利益相关者和最终用户的需求。在许多需要改进的领域中，创新的主要目标可能包括减轻门诊初级保健临床医生文件负担、识别需求并支持改善护理协调和结果的技术，重点关注以下关键领域：识别儿童和家庭护理需求、决策支持、文件、护理协调和家庭沟通。