Document Type

Conference Paper

Publication Date


Publication Title

Proceedings of the American Society for Engineering Management 2018 International Annual Conference


1-7 pp.

Conference Name

39th American Society for Engineering Management International Annual Conference, 17-20 October 2018, Coeur d'Alene, Idaho, USA


Beginning around 1990, efforts were initiated in the medical profession by the U.S. government to transition from paper based medical records to electronic medical records (EMR). By the late 1990s, EMR implementation had already encountered multiple barriers and failures. Then President Bush set forth the goal of implementing electronic health records (EHRs), nationwide within ten years. Again, progress toward EMR implementation was not realized. President Obama put new emphasis on promoting EMR and health care technology. The renewed emphasis did not overcome many of the original problems and induced new failures. Retrospective analyses suggest that failures were induced because programmers did not consider the medical socio-technical communications structures that had evolved around paper records. Transition to electronic records caused breakdowns in the medical socio-technical communications systems; induced inconsistencies in information exchanges among clinics, physicians, hospitals, laboratories, pharmacies, and health insurance providers; and resulted in the incorrect administration of prescriptions, errors in patient care, and unnecessary treatments and surgeries. With the rapid integration of machine intelligence (MI) in medical socio-technical systems, there is a potential to repeat the failures of EMR implementation. To address the MI integration issue, this paper reports research design into the development of a human-intelligent/machine intelligent (HI-MI) EMR core reference ontology around which EMR-MI knowledge can be encoded to form the basis for informed transition to artificially intelligent electronic medical records.


Included with the kind permission of the publisher.

Copyright, American Society for Engineering Management, 2018

Original Publication Citation

Zahedi, Z., & Cotter, T. S. (2018). Research agenda In developing core reference ontology for human-intelligence/machine-intelligence electronic medical records system. In E-H Ng, B. Nepal, E. Schott, & H. Keathley (Eds.), Proceedings of the American Society for Engineering Management 2018 International Annual Conference (1-7). American Society for Engineering Management (ASEM).