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Electronic medical/health record (EMR) usage in North America has increased significantly in the last half decade. But there is widespread dissatisfaction with the technologies that are currently available in the market place. Our hypothesis is that EMR vendors and the market place alone cannot solve the issue of poor technology. We propose an architecture for the next generation of electronic records that solves current concerns of end users and addresses the needs of additional stakeholders, including health system funders, patients, researchers and guideline implementers. By including additional stakeholders, we believe that additional resources, competencies and functionality can be unleashed to solve the larger problems of the current generation of EMRs. The architecture also addresses future requirements that are likely to arise from technological developments such as mobile apps and PHRs and from innovations in medicine, including genomics, artificial intelligence and personalized medicine. The paper makes a call to action for informatics researchers to play a greater role in R&D on EMRs.
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