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== '''What is the difference between the EMR and EHR?''' ==
== Intro: ==
The following info is pulled from 3 major sources regarding the EMR/EHR definitions and meaningful use. It is a combination of information from [www.himssanalytics.org]; [www.himssanalytics.org]; [https://www.ama-assn.org]. In the author’s opinion, these are 3 very influential organizations in relation to the development of the Electronic health Record in the United States.
The terms electronic medical record (EMR) and electronic health record (EHR) are often used interchangeably. [2,3] Technically, there is a distinction, but it's one that's been blurred by common usage.[3] While it may seem a little picky at first, the difference between the two terms is actually quite significant.[2] The EMR term came along first, and indeed, early EMRs were “medical.” They were for use by clinicians mostly for diagnosis and treatment. [2] At a minimum, EMR systems replicate all aspects of your paper charting. They are designed to facilitate all the documentation you do in your office already—lab results, visit notes, diagnostic test results, insurance information, demographics, health histories, medication information, and more.[3]
== EMR vs. EHR: Definitions ==
The definitions that HIMSS Analytics proposes for these terms are as follows:
Electronic Medical Record:
The EMR is a basic digitized replication of the paper record. It provides basic information for the EHR. The EHR represents the ability to easily share medical information among stakeholders and to have a patient s information follow him or her through the various modalities of care engaged by that individual. Stakeholders are composed of patients/consumers, healthcare providers, employers, and/or payers/insurers, including the government.[1]
Definition of an EHR
The Electronic Health Record (EHR) is a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EHR automates and streamlines the clinician's workflow. The EHR has the ability to generate a complete record of a clinical patient encounter - as well as supporting other care-related activities directly or indirectly via interface - including evidence-based decision support, quality management, and outcomes reporting.[1]
== What's the difference between EMR and EHR? ==
Electronic medical records (EMRs) are a digital version of the paper charts in the clinician’s office. An EMR contains the medical and treatment history of the patients in one practice.[2] The EMR is an application environment composed of the clinical data repository, clinical decision support, controlled medical vocabulary, order entry, computerized provider order entry, pharmacy, and clinical documentation applications. This environment supports the patient s electronic medical record across inpatient and outpatient environments, and is used by healthcare practitioners to document, monitor, and manage health care delivery within a care delivery organization (CDO). The data in the EMR is the legal record of what happened to the patient during their encounter at the CDO and is owned by the CDO.[1] EMRs have advantages over paper records. For example, EMRs allow clinicians to:
• Track data over time
• Easily identify which patients are due for preventive screenings or checkups
• Check how their patients are doing on certain parameters—such as blood pressure readings or vaccinations
• Monitor and improve overall quality of care within the practice
But the information in EMRs doesn’t travel easily out of the practice. In fact, the patient’s record might even have to be printed out and delivered by mail to specialists and other members of the care team. In that regard, EMRs are not much better than a paper record.[2]
EHRs, on the other hand, are essentially EMRs with the capacity for greater electronic exchange; that is, they may be able to follow patients from practice to practice and allow for things like data exchange and messaging between physicians (3), presently assumed to be summaries like ASTM s Continuity of Care Record (CCR) or HL7 s Continuity of Care Document (CCD), is owned by the patient and has patient input and access that spans episodes of care across multiple CDOs within a community, region, or state (or in some countries.[1]
Electronic health records (EHRs) focus on the total health of the patient—going beyond standard clinical data collected in the provider’s office and inclusive of a broader view on a patient’s care. EHRs are designed to reach out beyond the health organization that originally collects and compiles the information. They are built to share information with other health care providers, such as laboratories and specialists, so they contain information from all the clinicians involved in the patient’s care. The National Alliance for Health Information Technology stated that EHR data “can be created, managed, and consulted by authorized clinicians and staff across more than one healthcare organization.”[2]
The information moves with the patient—to the specialist, the hospital, the nursing home, the next state or even across the country. In comparing the differences between record types, HIMSS Analytics stated that, “The EHR represents the ability to easily share medical information among stakeholders and to have a patient’s information follow him or her through the various modalities of care engaged by that individual.” EHRs are designed to be accessed by all people involved in the patients care—including the patients themselves. Indeed, that is an explicit expectation in the Stage 1 definition of “meaningful use” of EHRs.[2]
And that makes all the difference. Because when information is shared in a secure way, it becomes more powerful. Health care is a team effort, and shared information supports that effort. After all, much of the value derived from the health care delivery system results from the effective communication of information from one party to another and, ultimately, the ability of multiple parties to engage in interactive communication of information.[2]
== What They Do ==
EHR systems can help physicians and office staff better navigate patient information before, during and after an office visit. Here are just a few of the multiple things that an EHR system may capture during a typical clinical visit.[3]
Before a patient even steps into your office, manage scheduling, patient registration and insurance status, health history, insurance status and medication lists; electronically preview a patient's medical history.[3]
During a patient's clinical visit, type in your clinical documentation, electronically prescribe medication, order tests and labs.[3]
After the patient leaves, manage billing, claims submittal and coding. Electronically communicate with their consulting providers, payers, labs and pharmacies. In some cases, allow patients to view their results through a patient portal.[3]
Benefits of EHRs
With fully functional EHRs, all members of the team have ready access to the latest information allowing for more coordinated, patient-centered care. With EHRs:
• The information gathered by the primary care provider tells the emergency department clinician about the patient’s life threatening allergy, so that care can be adjusted appropriately, even if the patient is unconscious.
• A patient can log on to his own record and see the trend of the lab results over the last year, which can help motivate him to take his medications and keep up with the lifestyle changes that have improved the numbers.
• The lab results run last week are already in the record to tell the specialist what she needs to know without running duplicate tests.
• The clinician’s notes from the patient’s hospital stay can help inform the discharge instructions and follow-up care and enable the patient to move from one care setting to another more smoothly.
== Certified EHR Technology ==
The Centers for Medicare & Medicaid Services states that Certified EHR Technology is either a:
• Complete EHR that meets the requirements included in the definition of a Qualified EHR and has been tested and certified, or a
• Combination of EHR Modules in which each constituent EHR Module has been tested and certified and the resultant combination also meets the requirements included in the definition of a Qualified EHR. [3]
== Conclusion ==
The author opines the EMR is a digitized record of a single medical based encounter. The EHR is the digitized health history of a patient within a healthcare organization/entity. It is capable of sharing/exchanging relevant data with other non-related healthcare organizations required by law or at the patient consent. It includes the EMR.
== References: ==
[1] Garets, D., Davis, M., Electronic Medical Records vs. Electronic Health Records: Yes, There Is a Difference. A HIMSS AnalyticsTM White Paper. HIMSS Analytics, LLC January 26, 2006. www.himssanalytics.org
[2] Garrett, P., Office of Communications ONC. Seidman, J. PhD. Director Meaningful Use, ONC. EMR vs. EHR – What is the Difference? www.himssanalytics.org/buzz-blog/electronic-health-and-medical-records/emr-vs-ehr-difference. January 4, 2011.
[3] What's the difference between EMR and EHR? https://www.ama-assn.org/ama/pub/physician-resources/health-information-technology/health-it-basics/emrs-ehrs.page