EMR and EHR
Should you implement an EMR or an EHR? Do you know the difference? Is there a difference?
In theory, and by definition, there is a difference and it should play into any provider’s clinical software selection. At the same time, marketing messages and technical terminology have clouded provider’s understanding of the two software definitions.
The National Alliance for Health Information Technology (NAHIT) with the Office of the National Coordinator for Health IT (ONC), have established definitions for EMR (electronic medical records), EHR (electronic health records) and PHR (personal health records) as follows:
EHR: The aggregate electronic record of health-related information on an individual that is created and gathered cumulatively across more than one healthcare organization and is managed and consulted by licensed clinicians and staff involved in the individual’s health and care.
EMR: The electronic record of health-related information on an individual that is created, gathered, managed, and consulted by licensed clinicians and staff from a single organization who are involved in the individual’s health and care.
By these definitions, an EHR is an EMR with interoperability (i.e. integration to other providers’ systems).
And for the record, Greenway provides a certified and customer-service award-winning EHR that is an integrated and single-database interoperability solution for clinical, financial and administrative practice needs.
Who Needs Which?
Marc Anderson, CEO of the healthcare technology advisory and research firm AC Group, says it comes down to the words “medical” and “health.”
An EHR will provide a more comprehensive view into a patient’s health and medical history by pulling information from other systems, providing clinical decision support and alerting providers to health maintenance requirements. It will help providers report and measure quality indicators for pay-for-performance incentives.
Meanwhile, an EMR is a more silo’d record of a single diagnosis or treatment, most likely used by a specialist. If your responsibility is taking care of one unique problem — perhaps an orthopedist setting a bone — then a stand-alone EMR software solution may well be sufficient. Certain specialists may not need information about patient history as much as they need specialty-specific workflows and templates.
Regardless of who is using which terms, the key decision process for selecting an EMR or EHR is to map out your organization’s requirements and methodically assess systems against those criteria.
Justin Barnes, Chairman Emeritus of the HIMSS Electronic Health Record Association (EHRA) and Vice President of Marketing, Industry and Government Affairs at Greenway Medical Technologies, believes “the future of healthcare IT is interoperability.”
And while Barnes is an advocate of the EHR terminology, he distills the following three criteria for selecting a digital records system:
- Current-year interoperability certification standards (CCHIT, HL7);
- A unique workflow that matches your practice and specialty, and;
- Excellent usability at the point of care.
If you purchase an EMR or EHR software suite with these three requirements, you should receive a significant ROI on your investment, and position yourself to receive Meaningful Use incentives and from specific payer programs such as PQRI and for electronic prescribing.
NAHIT has provided the following definition of a Personal Health Record (PHR)
PHR: An electronic, cumulative record of health-related information on an individual, drawn from multiple sources, that is created, gathered, and managed by the individual. The integrity of the data in the PHR and control of access to that data is the responsibility of the individual.
To be most effective, a PHR should include cumulative health information ranging from past and current illnesses, demographics, allergies, prescriptions and more. Given the nature of the PHR, it’s the individual’s responsibility to decide what information is stored, and who has access to it.
Greenway’s PrimePATIENT online patient portal provides data integration between the patient and provider as well as integration with the Greenway EHR PrimeSUITE, all while providing a channel for patient health history to be entered into a PHR.
Greenway has formed a partnership with Microsoft’s HealthVault PHR to further empower patients to control and maintain provider access to their health history.
So What Should I Implement?
Even with complete definitions in place, it can be difficult to evaluate EMRs and EHRs to determine which system to buy.
At the same time, most providers will make their decisions based on their IT budget and their career stage. A young physician will almost certainly want to lay the IT foundation for participating in the future vision for healthcare interoperability with solutions such as the Greenway EHR. They will likely be supported in this effort by their health system.
Meanwhile, a more mature physician that wants to “go paperless,” but is not an aggressive adopter of IT, may well opt for a stand-alone EMR system and forgo the costs and challenges of integration.
In the final analysis, it’s not whether your practice purchases a Greenway EHR or a Greenway EMR, the point is selecting the best electronic patient charting solution for your practice and your patients.