Electronic health records (EHRs) were meant to modernize healthcare—but instead, they may have reinforced many of the system’s biggest challenges.
In this episode of After the Chaos, Angela and Kandice reflect on their conversation with Melinda Kidder, DHA, MSN, RN, Chief Nursing Officer for the Office of the National Coordinator for Health IT, and a critical insight: EHRs didn’t fundamentally redesign healthcare—they simply digitized it. By replacing paper workflows with digital ones without rethinking how care is delivered, health systems introduced new layers of complexity, administrative burden, and fragmentation.
Today, clinicians face overwhelming inbox volumes, disconnected care teams, and patient engagement tools that often fail to reach even half of patients. Despite being one of the largest investments health systems have made, EHRs have fallen short in coordinating care, improving outcomes, or reducing burnout.
The conversation highlights a core issue in healthcare technology: solutions are often built without a clear understanding of the problem. Too many tools focus on features rather than outcomes, resulting in systems that feel disconnected from real clinical workflows.
Angela and Kandice explore what must change moving forward—starting with involving clinicians in design from the very beginning, aligning technology with real-world workflows, and measuring success based on whether problems are actually solved.
As AI rapidly enters healthcare, the stakes are even higher. This moment presents a rare opportunity: not just to digitize existing systems again, but to fundamentally redesign how care is delivered.
Listen to the full interview with Dr. Kidder here.
Full Transcript
AI-generated transcript. Accuracy may vary; please excuse any transcription errors.
Kandice Garcia, RN:
Hi, and welcome to After the Chaos. We’re going to talk about our recent conversation with Mindy and one idea that really stood out.
She said that implementing the electronic health record was essentially replacing the pen with the keyboard. That’s not how I think about technology. It shouldn’t just replicate what already exists—it should redesign how we work, how we interact, and how we deliver care.
I think part of why we’re stuck today is that the purpose of EHR implementation was never fully understood.
Angela Adams, RN:
I think you’re right. When we look back at meaningful use, it didn’t really modernize healthcare—it digitized it. We took a paper-based process and made it digital, often adding more burden instead of reducing it.
EHRs do a few things well. They handle billing, and they act as a repository of data. But they don’t connect care teams, orchestrate care, or ensure that information gets to the right person at the right time.
Instead, they’ve created fragmentation.
Take the in-basket. Physicians are receiving 77 to 100 messages a day while also seeing patients full time. That’s a breaking point.
And when we look at patient engagement tools like MyChart, even a 50% engagement rate is considered successful. That means there’s a 50% chance the patient never saw the message.
Kandice:
In theory, these systems are supposed to organize information and get it to the right people. But that only works if workflows are redesigned alongside the technology.
Instead, we often see solutions built without fully understanding the problem. When clinicians interact with these systems, it feels incomplete—like the technology only solves part of the challenge.
That gap creates frustration and burnout.
Clinicians need to be involved not just in identifying problems, but in designing, testing, and continuously improving the solutions. They are the only ones who can truly validate whether something works in practice.
Angela:
I completely agree. If clinicians aren’t involved from ideation through implementation, the technology will fail.
But we also have to respect their time. Instead of long, drawn-out committees, we can take a more iterative approach—bring them early concepts, gather feedback quickly, refine, and repeat.
We don’t need months of meetings. We need focused, rapid cycles of feedback and improvement.
Kandice:
And having clinical expertise on the technology team is critical.
Too many technology companies don’t have a single clinician involved. Without that perspective, it’s incredibly difficult to translate real-world problems into meaningful solutions.
That’s a major red flag.
Angela:
I see this often. Teams will walk through detailed product demos without clearly explaining the problem they’re solving.
It doesn’t matter how advanced the technology is if it doesn’t address a meaningful need.
If your solution ends up in a drawer, you didn’t solve the problem.
Kandice:
Exactly. Technology should be designed to prove that it solved the problem it set out to solve.
That means clearly defining the problem, aligning the solution, and measuring outcomes that reflect real impact.
Angela:
When we asked how to avoid repeating past mistakes, the answer was clear: don’t just digitize existing workflows—redesign them.
This is our opportunity with AI.
Healthcare has a chance to rethink how work gets done, reduce administrative burden, and build systems that actually support clinicians.
Kandice:
It requires a shift in mindset.
Healthcare often stays the same because it’s designed to produce the results we’re seeing. But there are people pushing for change—people willing to think differently, challenge assumptions, and bring in ideas from outside the system.
That’s what makes this moment so important.
Angela:
I agree. This is a chance to do things differently—and hopefully, to do them better.
