With 97% of health data currently going unused and clinician burnout at crisis levels, the healthcare industry is facing a critical inflection point: the transition from legacy “systems of record” to dynamic “systems of intelligence.” In this deep-dive interview, Sandra Johnson, Senior Vice President of Client Services at CliniComp, outlines the architecture of the “New Era EHR”—a platform defined not by static documentation, but by agility, true interoperability, and embedded AI.
Johnson explains why the traditional approach of incremental upgrades is failing to address foundational risks like system outages and data fragmentation, and she challenges leaders to rethink their modernization strategies. From bridging the divide between CIOs and clinical leaders to redefining long-term ROI, Johnson provides a strategic blueprint for organizations ready to adopt technology that actively drives clinical decisions rather than merely recording them.
How do you define a “New Era EHR,” and how does this new standard fundamentally differ from the legacy systems that dominated the market over the last decade?
Sandra Johnson, Senior Vice President, Client Services, CliniComp: New Era EHRs are defined by agility, intelligence, and true interoperability. Where legacy EHRs were built in silos, designed to capture data rather than connect it. New Era EHRs bridge fragmented systems and transform data into real-time clinical intelligence. It’s not about layering on more features; it’s about reimagining how data, workflows, and AI come together to empower clinicians and improve patient outcomes. These advances mark the shift from systems built merely for documentation to intelligent, integrated care platforms that actively drive clinical and operational decisions. Healthcare systems need partners with a New Era EHR mindset that believe in continuous innovation and providing an EHR platform that evolves alongside healthcare. Having a fully integrated, end-to-end EHR solution suite with embedded AI delivers meaningful insights at the point of care, eliminates downtime through seamless, behind-the-scenes upgrades, and gives providers more time with their patients and less time navigating technology.
What persistent pain points are currently forcing healthcare organizations to move past incremental upgrades and seriously consider a full EHR replacement or modernization strategy?
Sandra Johnson: Health systems are recognizing that incremental upgrades can’t fix foundational issues like interoperability gaps, fragmented data, and costly downtime. Right now, today, about 97% of health data goes unused because it is trapped in siloed EHRs that don’t or can’t effectively use, analyze, or share the valuable data contained within them. Data fragmentation becomes a compounding problem when there’s an outage. Within the last 10 years, more than 96% of hospitals reported at least one EHR outage every three years, and more than 70% of the time, that lasted longer than 8 hours, underscoring the major issues we’re seeing across healthcare. Patchwork solutions only add complexity, more interfaces to manage, more maintenance, and more operational risk. Today’s healthcare organizations are demanding scalability, interoperability, and sustainability. CIOs want a platform that can expand seamlessly across service lines or facilities without disruption. In a survey of CIOs earlier this year, we found that CIOs are looking to AI and interoperability to help them with these issues; more than a quarter of them said shared that increasing interoperability and data accessibility are a top priority for their AI strategy. Clinicians are also looking for reprieve; it’s well-documented that more than half of clinicians are experiencing burnout. They need technology that simplifies workflows and supports better care delivery, not another layer of friction. By embedding AI directly into the platform, health systems can reduce reliance on third-party tools, lower total cost of ownership, and unlock real-time clinical intelligence that drives faster, more informed decisions.
When a health system invests tens or hundreds of millions in a new EHR platform, what specific metrics (beyond simple implementation success) should CIOs be using to measure the long-term ROI and operational success?
Sandra Johnson: True ROI goes far beyond a successful go-live; it’s about sustained operational, clinical, and financial improvement over time. Implementation is the foundation, not the finish line. CIOs should measure ROI through a balance of financial and operational KPIs that reflect both system performance and clinical impact. These include clinician efficiency (time spent in the system vs. time with patients), uptime and reliability, data accuracy, and the speed of innovation deployment. Just as important are outcomes-based measures such as patient throughput, clinical quality indicators, compliance, reduction in denials, time to collections, and overall satisfaction for both clinicians and patients. Designing a platform around these outcomes is key. By delivering continuous performance, adaptability, and real-time insights, organizations realize measurable value across every service line, ensuring that their investment not only improves efficiency but also empowers clinicians and enhances the quality of care.
What is CliniComp’s perspective on the line between core EHR functionality and best-of-breed third-party applications? How should leaders determine what functionality must live within the EHR versus what should be handled by specialized vendors?
Sandra Johnson: We believe in balance and openness. EHRs should provide robust, end-to-end functionality across the enterprise; documentation, orders, imaging, analytics, and more, while remaining vendor agnostic and API-friendly. In the new era, integration shouldn’t require compromise. Core functionality should always live within the EHR to ensure continuity and real-time performance, but leaders should have the freedom to extend capabilities through interoperable, standards-based APIs. Having architecture that is built to support both is key. You truly need a fully integrated solution suite that plays well with others.
Given the shift to real-time, AI-driven intelligence, how essential is an open API strategy to a “New Era EHR”? Does the platform serve as a data source, a data consumer, or both?
Sandra Johnson: For any New Era EHR, an open API strategy is essential; it’s the backbone of a connected healthcare ecosystem, and it’s where hospital IT is headed. In a survey of CIOs earlier this year, we found that 55% of them believe AI can solve their greatest challenge: documentation burdens. Modern EHRs must function as both a data source and a data consumer, seamlessly exchanging information in real time. Importantly, they must also be built with interoperability in mind so that they can easily integrate emerging technologies while maintaining secure and reliable connections with already existing and in-use tools. The ability to integrate native AI directly into the end-to-end platform is crucial. This eliminates the need for external AI tools while ensuring that intelligence operates continuously in the background, augmenting decision-making, not interrupting it. An open framework ensures data fluidity across systems, enabling organizations to innovate freely while maintaining stability, security, and performance.
What common legacy workflow issues do new systems still struggle to solve, and how are modern platforms specifically designed to reduce the notorious “administrative burden” that drives clinician burnout?
Sandra Johnson: One of the biggest challenges legacy systems created, and many modern systems still struggle to overcome, is cognitive overload. Clinicians are burdened by fragmented workflows, excessive clicks, and too much irrelevant data competing for attention. These inefficiencies lead to frustration, burnout, and time lost at the bedside, where they really want to be. Modern platforms must be designed with the clinician at the center, and they must be intuitive, intelligent, and purposeful. The focus for new and upgrading systems should be on simplifying clinicians’ work, not adding complexity. To be truly meaningful, any new EHR must automate routine tasks, surface relevant information in real time, and eliminate downtime disruptions that derail workflows. Embedding AI and workflow automation natively within the EHR to reduce administrative burden at the source is imperative. Real-time insights replace manual chart reviews, automation minimizes redundant documentation, and a holistic patient view supports more timely, personalized care. The result is technology that gives clinicians back their most valuable resource, time with their patients.
Where do you typically see the greatest misalignment between CIOs (focused on architecture and cost) and Clinical Leaders (focused on outcomes and workflow) during an EHR evaluation? What steps can be taken to ensure both are aligned on a technology decision?
Sandra Johnson: CIOs often focus on infrastructure, scalability, security, and cost, while clinical leaders prioritize usability, workflow, and outcomes. While they both ultimately have the same end goal, a disconnect arises when each group views their EHR through their own lens, as either a technical project or a clinical tool, rather than as a shared strategic investment in patient care. The key to alignment is early, sustained collaboration. When clinical and IT stakeholders engage from the start and define shared goals, success metrics, and pain points, the organization ensures the EHR supports both operational efficiency and clinical excellence. We’ve seen the greatest success when alignment happens from day one. We partner closely with both CIOs and clinical leaders to build trust through transparency, co-design, and measure outcomes, ensuring every decision advances not just the IT strategy but the overall mission of improving patient care.
Beyond optimizing clinical documentation, how can a modernized EHR platform act as a proactive partner in driving a health system’s long-term strategic goals, such as population health management or value-based care readiness?
Sandra Johnson: A modern EHR should serve as the digital backbone for enterprise intelligence, powering population health, research, and value-based care initiatives. When data is unified, reliable, and continuously available, it transforms into a strategic asset that drives predictive modeling, operational planning, and system-wide optimization. Having a platform that provides that foundation with real-time data and analytics across clinical, operational, and financial domains enables proactive decision-making and aligns care delivery with long-term organizational goals.
Looking ahead three to five years, what single innovation (e.g., ambient AI, predictive analytics) will become the non-negotiable foundational standard for all EHR platforms?
Sandra Johnson: The next generation of EHRs will be defined by continuous, intelligent interoperability. AI will be embedded— not bolted on as an afterthought— across EHR platforms to enhance decisions, automate workflows, and improve safety. The real differentiator will real-time, standards-based data sharing and systems that never require disruptive downtime. The future standard will be vendor-neutral platforms that evolve with every interaction, turning data into continuous clinical intelligence that makes care more connected, reliable, and actionable.
Any final thoughts?
Sandra Johnson: Healthcare is entering a transformative era where technology can finally keep pace with clinical ambition. New Era EHRs are about more than modernization; they represent a true partner that connects people, data, and intelligence in real time. The goal is to help health systems move beyond static data systems to dynamic platforms that perform without interruption, evolve without disruption, and empower clinicians to focus on what matters most: delivering exceptional care for every patient, every day.
