Table 3.

Overview of provider-perspective vignette and associated gaps

Typical provider experience in the not-too-distant future	Gaps between the current provider experience and the future
1. Prior to the patient visit, the provider can access critical new test results and reports, relevant biomedical literature, and all patient information provided by the patient and previous providers within the EHR.	1. Lack of standardized APIs limits clinician access to external data and knowledge, advanced analytics, and other tools to provide patient-specific cognitive assistance integrated into the clinical workflow.29
2. Upon conducting the physical exam, the provider completes the note before leaving the exam room, using a template based on the patient’s profile and containing prepopulated information. The provider then generates an online specialist referral.	2. Providers typically must complete substantial documentation and abstraction to meet external requirements, in particular reporting of clinical quality measures.
3. Prompted by review of the patient note, the specialist wants further information about the patient’s risk based on family history. The specialist consults an online phenotyping algorithm, which returns a predictive analytic result indicating patient risk.	3. Knowledge-based tools using standard APIs are not widely available, and it is rare for health systems to encode and implement the required clinical knowledge in the form of clinical decision support.30