“Provider organizations will not thrive in an era of health reform simply because they have a superb and interoperable electronic health record. They will thrive because the care they deliver consistently follows a plan designed to ensure desired outcomes. The EHR must evolve so that it focuses on an individual patient’s care plans — the steps required to maintain or create health.”

And,

“Every patient’s EHR should clearly display the master care plan — a long-term care plan to maintain health integrated with short-term plans for transient conditions. The EHR should be organized according to this master plan: It should highlight the steps needed to recover or maintain health, list the expectations of every caregiver with whom the patient interacts, and include tools such as decision support and a library of standard care plans. Interoperability is a necessity, as various providers must be able to use the plan-based EHR. ”

And,

“The shift is underway. The electronic health record does not disappear as a result of this shift, but the strategic emphasis will move to technologies and applications that assist the care team (including the patient) in developing and managing the longitudinal, cross-venue health plan and assessing the outcomes of that plan.”