The healthcare landscape is rapidly evolving, demanding agility, innovation, and a patient-centred approach that traditional electronic health record (EHR) systems often struggle to provide. Better Platform offers a modern architectural approach known as the Postmodern EHR, designed to help healthcare organisations thrive in today’s fast-changing environment. This approach is gaining traction worldwide in leading hospitals and health systems, from Karolinska University Hospital to The Christie NHS Foundation Trust.
A Postmodern EHR is a data-centric, open platform that enables healthcare organisations to innovate faster, integrate easily, and place patients at the centre of care.
Traditional EHR versus Postmodern EHR
The limitations of traditional EHRs
For decades, traditional, monolithic EHR systems were seen as groundbreaking, aiming to be comprehensive solutions for everything from patient records to billing. However, their rigid, closed architectures have become roadblocks to innovation and flexibility in healthcare IT.
Key challenges:
- Lack of customisation and rigidity
Unable to adapt to the unique workflows of different medical specialties. - High costs
Implementation, upgrades and maintenance are expensive and time-consuming. - Vendor lock-in
Dependence on a single vendor severely limits innovation. - Interoperability challenges
Fragmented data and poor communication create data silos. - Poor user experience
Clinicians report frustration, which contributes to burnout.
These limitations reduce efficiency for healthcare providers and, ultimately, affect patient outcomes.
Embracing the Postmodern EHR: an evolution, not a revolution
The Postmodern EHR is not about discarding everything you already have. It is about rethinking the foundations of healthcare IT and extending where traditional systems stop.
Key attributes:
- Open: Powered by open data standards such as openEHR, FHIR and SNOMED CT.
- Collaborative: Tools and standards that enable clinicians, developers and designers to work together.
- Modular: Add new applications or capabilities when needed, without disrupting core systems.
- Patient and data centric: A longitudinal, cradle-to-grave patient record at the centre of workflows and decision making.
This hybrid approach integrates legacy systems with best-of-breed, pre-integrated applications built on a vendor-neutral clinical data repository (CDR).
By unlocking data and embracing an open, modular ecosystem, the Postmodern EHR provides a sustainable path to modern, data-driven, and patient-centred healthcare.
Key difference
- Traditional EHRs lock data inside proprietary software.
- Postmodern EHRs free data and enable flexibility.
Key principles of a Postmodern EHR
- A Digital Health Platform (DHP) is the enabling layer that makes composable architecture possible.
- A Clinical Data Repository (CDR) forms the single source of truth.
- · Data is longitudinal, standardised, and open, enabling population health, research, and analytics.
- Interoperability and open standards
- openEHR and open APIs ensure seamless data exchange.
- Avoids reinventing integration projects for every new application.
- Composable, modular architecture
- Select best-of-breed applications for different workflows.
- Combine legacy systems with new digital tools on one platform.
- Empowering innovation with low-code
- Clinicians and healthcare professionals can develop their own applications without waiting years for IT projects.
- Reduces backlogs and encourages user-driven innovation.
- Patient-centricity
- Patients gain better access to their data and benefit from data-driven care.
The Digital Health Platform as an enabler
Industry analysts, including Gartner, consistently identify the Digital Health Platform as a cornerstone for transforming healthcare IT. It provides the architecture, tools and ecosystem that make the Postmodern EHR possible.
At its core, a Digital Health Platform is built on three key pillars:
1. Shared data layer: open and vendor-neutral
- A secure, open, and vendor-neutral data repository.
- Clinical and operational data is stored in a common, standardised format (openEHR, FHIR), enabling:
- Seamless interoperability across applications.
- The removal of data silos.
- Future-proof access to patient data, regardless of technology changes.
2. Low-code, microservices and APIs: tools for agility
- The platform exposes APIs, microservices and SDKs that allow teams to:
- Leverage low-code development tools to respond rapidly to clinical needs.
- Integrate legacy systems quickly and efficiently.
- Build custom workflows and applications.
- This architecture encourages experimentation and innovation, empowering clinicians, citizen developers and IT teams to deliver solutions faster without compromising governance.
3. Open ecosystem of apps and knowledge
- A Digital Health Platform nurtures an ecosystem of interoperable applications:
- clinical decision support tools,
- care coordination applications,
- patient summaries and population dashboards,
- AI-driven insights and automation.
- Beyond software, this ecosystem fosters a community of clinical knowledge:
- shared archetypes, templates and clinical models,
- contributions from global experts ensure consistency, safety and reusability.
This community-driven model accelerates innovation and allows healthcare organisations to benefit from shared best practice.
An ecosystem, not a single monolith
A Postmodern EHR, built on a Digital Health Platform, is not a single monolithic system.
It is a dynamic ecosystem:
- where data is unified,
- applications are interchangeable,
- innovation is continuous.
This is the foundation for a patient-centred, agile and future-ready healthcare IT environment.
Benefits for healthcare organisations
Agility
Scale up gradually, add modules as needed.
Cost efficiency
Avoid large, multi-year projects.
Innovation
Empower clinicians and citizen developers.
Governance
Strong data management, security and compliance.
Sustainability
Long-term flexibility and resilience against future change.
Interoperability
Seamlessly connect systems, applications, and devices using open standards to enable coordinated, data-driven care.
Real-world examples
Early adopters include:
Karolinska University Hospital (Sweden)
Combining legacy systems with new modular applications
The Christie NHS Foundation Trust (UK)
Enabling clinician-driven app development
Slovenia and UK regional projects
Evolving to shared care records using open data standards
The role of AI in a Postmodern EHR
AI thrives on high-quality, standardised data:
- Automates summaries and documentation
- Enables predictive analytics, decision support and precision medicine
- Enhances patient outcomes by personalising care
Transitioning to a Postmodern EHR
Steps to get started:
- Adopt open standards such as openEHR and FHIR.
- Create a central vendor-neutral data layer.
- Use low-code tools to address gaps quickly.
- Integrate legacy systems using APIs.
- Iterate gradually – start small and grow over time.
Ready to begin your transformation?
Talk to our team about how a Postmodern EHR approach can help you create a more flexible, open and patient-centred healthcare IT environment.
