Healthcare AI at Risk of Repeating Past Mistakes

The concept of the problem-oriented medical record (POMR) was first introduced in 1968 by Lawrence Weed in his paper 'Medical Records that Guide and Teach' published in the New England Journal of Medicine.

Weed's POMR organized a patient's chart around their specific problems, rather than by department or data source. This approach revolutionized patient records and became federal law: every certified Electronic Health Record (EHR) is required to maintain one.

However, over time, the problem list was forgotten, and EHR use focused on billing and reimbursement. As a result, problem lists became something coders translated into billing codes rather than capturing a clinician's actual reasoning.

Warner Slack, a pioneer in healthcare technology, recognized this issue and urged others to 'remember the patients.' He believed that when a record built to serve a patient starts serving something else, it can lead to negative consequences for the patient.