ABSTRACT
With the enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, hospitals and physician practices across the country converted from a system of paper recordkeeping to fully integrated electronic health records (EHR).1, 2 With financial incentives in hand, there was a rush to market to acquire and implement these systems. Fast-forward 10 years, and it is apparent that the EHR space has significantly evolved in technology, processes, and policies.3 These changes should make organizations examine their EHR and organizational models and consider if they are using the best EHR to meet their organizational needs for the next 20 years. The National Institutes of Health (NIH) Clinical Center (CC) implemented its EHR in 2004 and, recognizing all of the new participants, technologies, and the advancement of clinical research needs since then, made the decision to embark on a comprehensive business case analysis to evaluate the best solution to meet the CC's and NIH's needs over the next 20 years. The goal was to answer this question: "Given the evolution of the EHR market, is the CC on the best platform to meet its needs now and in the future?"
