Health IT industry news followers have probably noticed industry confusion and inconsistencies regarding terminology about what to call patient information that is collected and shared electronically.
In fact, analysts, vendors, journalists and practitioners all are guilty of using the terms electronic medical record (EMR) and electronic health record (EHR) interchangeably as if they are one and the same. In fact, these are two different terms that address two different sets of business needs with different — although overlapping — sets of features and capabilities. The distinction is more than minor semantics, and it’s crucial for health IT decision-makers to understand the difference.
Electronic record
To many, an electronic record is considered to be any clinical record that isn’t paper-based or hanging on a clipboard. The problem is, this doesn’t describe how the data will be used, gathered or shared. Will the electronic record be used only within the confines of a single office or practitioner, or within a single regional health system? Alternatively, will the data be shared across a wide range of different providers, such as specialists’ offices, labs, insurance providers and government agencies? For the sake of clarity and accurate understanding, it is important to distinguish between electronic records that can be shared widely and those that are designed to reside within a single organization.
When discussing digitized medical records, depending on the software vendor, geographic region, country or even the personal preferences of the presenter, the two terms — EMR and EHR — are being used interchangeably. Unfortunately, that distinction has been lost in the flood of material appearing in the literature.
According to the Healthcare Information and Management Systems Society (HIMSS), an EMR is a component of an electronic health record that is owned by the health care provider. The EMR is a set of applications and workflow tools that digitizes the creation, collection, storage and management of patient information within the confines of a single organization. An EMR system may touch clinical data repositories, lab applications and patient information management systems, among others — but all within the reach of a single organization.
EHRs, on the other hand, comprise as far as is possible, a complete and unified view of all the patient’s clinical assessments and care records drawn from across a wide region corresponding to all the providers who are seeing the patient — the totality of his/her personal data, state of health and delivered care. HIMSS defines EHR as a longitudinal electronic record of patient health information produced by encounters in one or more care settings.
An EHR consists of data provided from organizations throughout the service delivery chain — laboratories, providers, pharmacists, insurance payment records — as well as all of the patient’s personal data such as date of birth, address, weight, provider visits, and so on. These records can be shared easily across separate health care providers, labs, government agencies and insurance companies, made available whenever and wherever the patient is seen
Improved workflow
While both EMRs and EHRs provide some similar benefits — cost savings through improved workflow and paper reduction, improved delivery of care accuracy — EMRs provide those benefits only within a single organization. EHRs, because they are shared across the irrelevant geographic or otherwise defined region, increase the efficiency of patient care and improve patient outcomes, disseminate information rapidly between care providers, help with research efforts, and cut costs throughout the entire system more promptly and reliably.
The industry may be confused about what exactly is the difference between an EMR and an EHR, but there should be no confusion about the type of solution an organization needs. The benefits associated with sharing patient information with partners, suppliers and insurance companies can only be achieved through an EHR. In the years ahead, solutions that survive this rapidly changing market must be capable of sharing electronic patient information effectively both within an organization, between facilities and across regions. Health care organizations need to ensure that they are laying the groundwork today to make that future collaboration possible.
