You’re in the year 2040…..

In this ideal healthcare setting, physicians, nurses, and other health care practitioners would simply take care of their patients without having to think much about health records at all. They would devote most of their time and attention to interacting with the patient. Whatever the outcome of the examination, relevant information would flow seamlessly to all parties necessary to handle the patient’s progress through the health care system—to insurance companies, hospitals, other physicians, and the patient. In terms of the electronic health record itself, this means that the EHR would be populated with little or no effort. When the nurse or doctor takes vital signs, these would be automatically uploaded.

All the relevant information would be uploaded in a Nationalized Database maintained in a secure location with quantum-grade encryption technology that would be accessible to a bunch of academic research organizations, public health organizations like the CDC, healthcare providers and patients alike to download or view in different formats according to their permissions.

In the exam room, an automated physician’s assistant would listen to the interaction between doctor and patient, and, based on the communication in the room and verbal cues from the clinicians, record all relevant information in the physical exam. The automated physician’s assistant would also offer options for taking action. It would use artificial intelligence (AI) technology to synthesize medical literature, the patient’s history, and relevant histories of other patients whose records would be available in anonymized, aggregated form. When the assistant hears a complaint from the patient, the EHR would populate different possible diagnoses for the clinician to investigate. It would also be sensitive to an individual patient’s characteristics—lifestyle, medication history, genetic makeup—and bring all the relevant medical knowledge to bear on what would be best treatment options for a particular patient. This kind of medical decision-making support would bring Precision Health into the doctor’s practice, with the goal of keeping people healthy.

Knowledge would flow not only to the clinician that is caring for a particular patient but also to public health officials interested in the population at large. We can imagine a future where EHRs are part of a rich, seamless data stream that facilitates doctor-patient rapport even as it delivers real-time diagnostic support. Clinicians would be free to do what they do best: use their brains and interact with other human beings.