Medical records on laptop screen

Is it EHR or EMR….?

Let’s test the sharpness of your vocabulary – what’s the difference between Intranet and Internet, or Lawyer and Advocate?

Equally capricious is when you work in healthcare services but need to Google the difference between an EMR and an EHR? Don’t feel bad if you’re not sure; because 90% of the industry participants I work with didn’t know the difference either.

I’ve been working in healthcare services for over two decades, but it was just a couple of years ago I realized EMRs and EHRs are not the same. It took a bit of researching and consulting with friends who work for major EHR companies to confirm the differences, but they are certainly not the same. Honestly, I was a little dumbfounded to learn most doctors who use EHRs day in and day out didn’t know the differences either.

In my pursuit to confirm the differences, the funniest explanation I received came from a cardiologist friend of mine with over 30 years of experience running a thriving practice. He said he uses the term EMR “Because whenever I write EHR, it keeps getting autocorrected as “HER,” so I use EMR!!” While admitting that, he conceded even he didn’t know the real difference. The fact of the matter is EHR and EMR are often used interchangeably, even though they are quite different.

What is an EMR?

An Electronic Medical Records (EMR) is a modern-day digital format of the old hand-written or typed Paper Charts of a patient. EMR documents are mostly used within the doctor’s office or hospital and include information about the patient’s treatment history, clinical data, notes on a medical condition, and treatment plans. EMR documents typically stay in the office of the doctor or hospital that the patient visits. Such records normally cannot be assessed outside the office or hospital network. If the patient gets referred to an outside specialty or facility, these digital records are moved physically (typically printed) or digitally (mostly by faxed) to the outside entity. Often, if the patient decides to move their care to a different doctor, his/her medical records don’t get shared unless specific encounter records are specifically requested.

What is an EHR?

An Electronic Health Record (EHR) includes everything an EMR has but can be accessed within or outside the system through file interoperability. EHRs allow sharing and access of patient records and data within highly secured exchanges, allowing a patient’s health information to follow them wherever they go. These portable individual records and aggregated health data provide doctors more comprehensive access to not only an individual patient’s medical history, but overall population health statistics. Accordingly, an EHR enables doctors to communicate and exchange with one another quickly and accurately in real-time.

Beyond the interoperability, EHRs are highly customizable to the requirements of different medical practice workflows or specialties. It is not an exaggeration to say they have revolutionized healthcare by providing an assortment of customized functionalities to doctors, hospitals, and other service providers. It helps the hospital and doctor with more accurate analytics, supporting improved patient care, diagnosis accuracy, and even access to proven alternative treatment options.

These expanded EHR capabilities are getting smarter and more reliable, and the scope of their features and functionalities are only getting bigger.

As per the Institute of Medicine (IOM) core functionalities of an EHR system include:

  • Health information and data.
  • Results management.
  • Order entry/management.
  • Decision support management.
  • Electronic communication and connectivity.
  • Patient support.
  • Administrative processes.
  • Reporting & population health.

Vocabulary Wrap-up:

Intranet is only accessible within a closed group and has limited reach, whereas Internet offers a wider reach and accessibility outside a closed group.

A Lawyer refers to any person who has a law degree. There can be various types of lawyers, but an Advocate is a lawyer who has completed a law degree and is eligible to stand in court on behalf of his/her clients to represent their best interests to others. Advocates are Lawyers but all Lawyers are not Advocates.

EMRs are a collection of Intranet-like, limited access individual patient medical records used almost exclusively by the attending physician, while EHRs offer Internet-like, portable, patient records and health data, which enable access to improved decision support functions and overall population health influencing data exchanges available (through highly secure protocols) to authorized third parties.  EMR data is included in EHRs but EHR functions are not available in EMRs.

Hope you now understand why I chose to tie Intranet Vs Internet and Lawyer Vs Advocate to help explain the difference between EMRs and EHRs.  The former of the three are old-school or internally focused efforts while the latter is designed to be open and inherently interactive with others.

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