May 18, 2015

EHR vs. EMR: Is There Any Difference?

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If you’re involved in medicine in America, you’ve likely heard the terms electronic health records (EHR) and electronic medical records (EMR) used interchangeably. When pondering EHR vs. EMR, you may have thought to yourself, “what’s the difference anyway?” Today, we’re going to dive deep into that very question and see if we can’t drum up a good answer for you.

EMR Defined

Beginning with the post-World War II Veterans Administration’s efforts to computerize their health records and continuing today, electronic medical records have been developed to centralize and normalize healthcare information and delivery. The term electronic health records did not emerge until much later, during the 2000s, and thus the confusion began. If you asked someone to define an EMR, then followed their answer by asking them to define an EHR, it’s likely that his or her answer would be the same. According to HealthIT.gov:

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…EMRs allow clinicians to track data over time, easily identify which patients are due for preventative screenings or checkups, check how their patients are doing on certain parameters — such as blood pressure readings or vaccinations — and monitor and improve overall quality of care within the practice.

To paraphrase, EMRs are a digital representation of the information that would have previously been stored in patients’ paper charts. Capturing this information electronically allows for easier population health modeling, tracking of community health issues, and provides an easily searchable, historical data store. So, is there any difference between this and an EHR?

EHR Defined

The term ‘electronic health records’ didn’t really emerge until 2004, when then-President George W. Bush mentioned it in his State of the Union address, announcing his initiative to make electronic health records available to most Americans within the next 10 years. In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act saw the beginnings of the Meaningful Use Incentive program. As part of this, the Center for Medicare and Medicaid Services (CMS) established certain features and functions that Certified Electronic Health Records Technology (CEHRT) must have in order for users to qualify for incentives. You can read more information about the incentive program’s background in our article: Meaningful Use in 2015: A History of Meaningful Use. According to HealthIT.gov:

Electronic Health Records (EHRs) do [all the things done by EMRs] — and more. 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.

So, could we just call an EHR a better, more up-to-date version of an EMR? They both capture clinical data and allow it to be searched and managed, but an EHR takes it a step further and is focused on exchanging that data with other providers, making sure patient information can flow across the continuum of care.

Can Something Be Both an EHR and EMR?

Since the terms are used interchangeably, the short version is: yes, something can be both an EMR and EHR. There are several software systems that are classified by CMS as CEHRT, even though the vendors market their systems as an EMR. It’s entirely possible that these companies are maintaining their branding as EMRs out of a desire to not confuse long-time customers. Also, it’s worth noting that the majority of systems still marketed as EMRs tend to be for hospitals or larger physician groups. Perhaps we could start calling EMRs “Enterprise Medical Records”?

Personal Health Records

Somewhat newer than EHRs or EMRs is the personal health record, or PHR. Though they’re closely related to electronic health records, personal health records have a few key differences. First, the patient is responsible for their curation, not the physician. As a result, the information contained within is less clinical — think of a PHR as an electronic health history form. Similar to the forms filled out during registration with a new provider, a PHR contains information about past medical procedures, family health history, etc. It also usually supports digital radiography storage, including X-rays, MRIs, and other images. Unlike EHRs and EMRs, there aren’t many purpose-built PHRs on the market today, so you’re just as likely to see a patient using a cloud storage provider like Google Drive or a note-taking application like Evernote in place of a formal PHR.

Benefits of Electronic Records

To fully consider the benefits of electronic medical or health records, one must consider the system they replaced: paper records. Although some providers may yearn for the “good old days” of paper charts and handwritten notes, most providers today agree that paper-based charting was a nightmare. If nothing else, physician handwriting is so notoriously bad that it has become a pop culture phenomenon. Deciphering the patient’s history and the previous orders caused many headaches — and that’s assuming you could find the patient’s chart at all. Despite the considerable growing pains experienced by many when adopting electronic records, most will agree that they’re a better system than what they replaced.

In the real world, there’s little difference between EMRs and EHRs. The terms can be used interchangeably — everyone will know what you’re talking about. For the technically-minded, yes, EHRs are focused more on the exchange of patient health information between care stakeholders, and EMRs are the legacy systems that are simply digital representations of the patient’s chart. Of course, once everyone truly decides on a definition, it’s entirely possible we’ll be calling them something completely different.

Have questions about EHRs or EMRs? Let us know in the comments.

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