Informatics Information Systems and History Peer Reviewed Journal

electronic medical records have yet to become standardized in the United States, the contemporary physician's office differs significantly from one from twenty years ago. Information systems govern multiple aspects of care delivery, from patient intake, processing, and billing to medical records, access to electronic scholarly databases for knowledge management to purchasing and human resources management. Understanding issues like the system development life cycle (SDLC) and project management life cycles have now become common practice in most healthcare offices, whereas twenty years ago only the most cutting edge of those offices would have dedicated information technology specialists who would handle and address matters like product life cycles. Full time consultants or advisory positions related directly to IT are now expected of most medical practices. Since the Health Insurance Portability and Accountability Act (HIPAA) was passed just over twenty years ago, physicians offices have made significant strides by incorporating informatics into their workplace environments, but there is still a long way to go before physicians" offices reap the full benefits of healthcare information technologies.

As Grandia (n.d.) points out, the most significant uses for information technologies in healthcare during the early 2000s was for outcomes-based reimbursement, revealing the intense focus on finance and profit by the American healthcare system. The emergence of cloud-based computing options reduced the amount of space physicians' offices needed to devote to their information systems, and this has helped streamline contemporary offices. Now, the hardware footprint in most physicians' offices is smaller than it was twenty years ago even though the software systems, databases, and storage solutions are more robust than they once were.

Significant landmarks in the evolution of technology in healthcare include the establishment of the Office of the National Coordinator for Health Information Technology in 2004, the American Health Informatics Consortium in 2005, and the Health Information Technology Standards Panel (HITSP), also in 2005 (Sewell, J.P. & Thede, L.Q., 2012). Moreover, hardware developers began creating portable devices that were feasible for personal and office use, allowing nurses and other healthcare workers in remote locations to enhance continuity of care for patients who use multiple healthcare facilities. Portable electronic devices in physicians' offices permitted bedside care to be more efficient and to reduce medical errors, as information could be stored in a cloud and accessed on any portable or stationary device. Unfortunately, the plethora of medical information systems being offered has led to a…