The Intelligent Medical Record: Reimagining the Future of Oncology Care

For decades, the electronic medical record (EMR) has been the backbone of care delivery—a system designed to document, store, and retrieve patient information. But in community oncology, the demands have outgrown that original intent.

Today’s providers are navigating increasingly complex treatment pathways, rapidly evolving precision therapies, fragmented data sources, and mounting administrative burden compounded by countless, disparate artificial intelligence (AI)-driven point solutions, all while being asked to deliver more personalized, higher-quality care in a resource-constrained environment.

The traditional EMR was built to capture the record. It was also built around the encounter note as the central organizing unit of care. But care is not episodic, and the encounter note is increasingly insufficient for managing the complexity of modern oncology care. Community oncology needs a system that actively enables care. This is the shift underway: from EMR to what we see as the future, the intelligent medical record (iMR).

From Documentation to Orchestration

The iMR is not a feature, and it is not a rebrand of the EMR. It represents a multi-faceted, interlocking platform strategy that brings together the user, clinical systems, data, and workflows used across the care team into a workflow-native system of engagement.

In this model, the record is no longer the end point. It becomes the foundation for a continuously updated, longitudinal understanding of the patient’s cancer journey by integrating diagnosis, biomarkers, treatments, clinical support, and decisions into a living clinical story.

Rather than requiring providers to navigate systems, the iMR moves with the workflow, reducing friction and informing decision-making by providing timely, relevant information.

What distinguishes the iMR from traditional EMRs is not a single feature or technology but the convergence of key capabilities working together. Each addresses a longstanding challenge in community oncology while contributing to a more connected care experience.

AI Embedded Across the Workflow

AI is often discussed in terms of individual capabilities, but we believe the real value in community oncology can be realized by embedding across the entirety of care delivery.

Ambient documentation is one visible piece, but only one. More broadly, AI holds promise in:

• Reduction of documentation and administrative burden across the care team
• Continuous understanding of clinical context within the workflow
• Proactive delivery of insights at critical decision points to support clinician judgment
• Continuous identification of missing data, clinical gaps, and surfacing options for consideration across the patient journey.

The goal is not to add another layer of technology, but to reduce the burden, needless complexity, and friction that get in the way of care. The EMR remains an important tool, but it is only one part of the broader ecosystem the care team depends on every day. In this model, administrative outputs such as documentation, coding, reporting, and other downstream tasks should increasingly flow from clinical evidence and activities rather than driving the workflow itself.

That requires AI-enabled workflows that operate across systems, not only in the EMR. The workflow of the future is not confined to a single user interface. It is orchestrated across platforms, using agents and automation to connect data, streamline tasks, surface the right insight at the right time, and help clinicians and care teams focus on higher-value care.

Precision Medicine, Made Operational

Precision medicine has transformed what is possible in oncology. Yet, in many community settings, accessing, ordering, and acting on these insights remains fragmented. The opportunity is not simply to make more data available, but to reconcile fragmented oncology evidence into a usable clinical understanding.

The iMR will bring precision medicine into the core workflow by:

• Enabling ordering and results visibility within a unified experience
• Normalizing and structuring lab data in ways that support patient outcomes, provider awareness, and orchestration
• Supporting the broader oncology ecosystem with consistent, high-quality data
• Reconciling genomics, pathology, imaging, and treatment data into a more cohesive, holistic view of the patient
• Surfacing potential biomarker gaps and relevant therapy or trial considerations for clinician review

This helps ensure that precision insights are available at the right moment and integrated into decision-making, rather than sitting outside of it.

Clinical Trials as a Natural Extension of Care

For community oncology, clinical trials represent both opportunity and complexity. Historically, trial identification and participation have required separate systems and workflows, creating barriers to access. The iMR helps bridge that separation by embedding clinical trial capabilities directly into the care experience:

• Surfacing objective, data-driven eligibility in near real time for clinician review and consideration at critical moments in the patient journey
• Aligning trial participation with established practice workflows
• Informing clinicians and clinical systems with critical test data previously trapped inside the note

This approach helps make clinical trials a natural extension of care delivery, broadening access for patients and providers alike.

Insight that Learns—and Improves

Data in oncology is abundant. Actionable insight is not. The iMR seeks to address this by embedding intelligence in two ways:

• Delivering in-workflow insights that guide real-time clinical and operational decisions
• Enabling a broader knowledge system that continuously aggregates and applies learnings across community practices

By grounding insights in source-linked clinical evidence, recommendations can become more transparent, traceable, and actionable.

In this model, every interaction can contribute to a larger system of engagement. Community oncologists should be supported by a connected, interactive, and intelligent system for patient care, one that brings together data, evidence, and workflow to help insights improve over time.

Building for the Future of Community Oncology

The expectations placed on community oncology will continue to increase. Providers will be asked to deliver more precise, more coordinated, and more efficient care and will increasingly require less friction and fewer clicks in their workflows.

Meeting that challenge requires more than incremental improvements to the EMR. It requires a redefinition of what the system is meant to do. The iMR has the potential to establish a new standard, one where:

• Workflows drive the experience
• Intelligence is embedded, not accessed
• Data enables action in the moment it matters
• Clinical truth becomes the foundation, with administrative outputs flowing downstream from it

For community oncology, this is not just a technology shift. It represents an evolution in how care is delivered, scaled, and improved.

And it is the future we are building toward.

Rob Helton, DPT, is chief product officer, Ontada by McKesson.