My ¢2 as someone who works in the space: EHRs are currently mandatory for compliance, reporting, and billing reasons — but completely unnecessary for the practice of medicine.

The first big step towards untangling the gordian knot in my book is pivoting the industry to a capitated payment model, so compensation doesn’t require tying everything back to CPT & ICD codes, or tracking super-anal quality metrics for CMS. Once you make that jump, it’s pretty easy to imagine a lightweight note-taking + file-hosting platform that lets providers document summary data on a patient profile wiki-style, and attach notes to the profile in any arbitrary format using customizable templates. (I’m basically picturing a mashup of Google Drive + Wiki.js + Obsidian features.)

Handling meds, orders, and referrals in a cross-platform way is starting to become a solved problem with FHIR. Tack on modular plugins for each of the above to the patient profile page, and you’ve reinvented the functionality of an EMR in a way that sucks far less and lets users get shit done.