Electronic health record (EHR) systems are not a new idea. A short YouTube video entitled “1961 Electronic Medical Records” discusses a project that Akron General Hospital in Ohio undertook in the early 1960s. The grainy black-and-white film shows the hospital's newly installed, very large computers being used by satisfied clinicians. The narrator enthusiastically asserts that thanks to the new technology, “It is going to be possible to relieve the nurses and doctors of some of their paperwork. It is going to be possible to have correlation of diseases which we have not had before. And it is going to be possible to eliminate errors in medications and tests of this kind which would have been harmful to the patients.”

In truth, however, EHRs did not begin to take off until forty years later, in the early twenty-first century. On April 26, 2004, President George W. Bush announced a plan to ensure that all Americans’ health records would be computerized within ten years. The following day, the president issued an executive order establishing the position of National Health Information Technology Coordinator to promote implementation of a “nationwide interoperable health information technology infrastructure.” At the same time, many other developed countries in Europe and elsewhere undertook major initiatives to transition to use of EHR systems.

Arguably, it was high time that medical professionals digitize their practices. Almost all other industries had long ago embraced computerization. Nevertheless, the rate of adoption of EHR systems was quite low at first. By 2008, only 17 percent of doctors’ offices and 10 percent of hospitals had basic EHR systems in the United States. In Europe, by 2007, only seven countries routinely used EHRs. The transition from paper medical records to EHR systems was proving to be far more complicated, cumbersome, and hazardous than many anticipated.

In 2009, as part of President Obama's economic stimulus plan, Congress enacted the Health Information Technology for Economic and Clinical Health (HITECH) Act. This law dedicated approximately $27 billion to promoting health information technology, including incentive payments for healthcare providers who adopted and appropriately used certified EHR systems. As a result, by 2013, 70 percent of US physicians had implemented at least a basic EHR system, and 76 percent of US hospitals had done so by 2014.