From The Editor | August 17, 2009

EMR Or EHR: What's In A Name?

The Potential Cost Of A Medical Device Tax

By Ken Congdon, Health IT Outcomes

In my coverage of the healthcare technology industry, I've noticed that many software and hardware vendors, clinicians, and even some analysts tend to use the terms EMR (electronic medical record) and EHR (electronic health record) interchangeably. However, according to the National Alliance for Health Information Technology (NAHIT), there is a distinct difference between the two.

The NAHIT defines EMR and EHR as follows:
EMR — The electronic record of health-related information of 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.

EHR — The aggregate electronic record of health-related information of 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.

In other words, an EMR is a somewhat siloed record of a single diagnosis or treatment, most likely used by a single practice or specialist. Meanwhile, an EHR is a more comprehensive record that is interoperable with and compiles information from multiple medical providers' systems.

Don't Judge A Software Package Based On Name Alone
Despite the NAHIT definitions, it's obvious that the industry is still unclear on how to delineate EMRs from EHRs. For example, some software vendors brand their technologies as EHR platforms when, in reality, they don't provide interoperability capabilities and would therefore be more accurately marketed as EMRs. At the same time, other vendors brand their products as EMR packages when they actually provide more comprehensive EHR frameworks. In fact, analysis of software packages currently on the market indicates that the latter is more likely to be the case, as most clinical records software vendors tend to brand their products as EMRs as opposed to EHRs. However, the term EHR does seem to be gaining popularity as it is the phrase used by President Obama in his healthcare stimulus talks and is the prominent terminology used in the American Recovery and Reinvestment Act of 2009 (ARRA).

Knowing that the terms used to brand clinical records software aren't always accurate, you must dig deeper to ensure a software platform you're assessing is equipped to meet the needs of your facility and your patients. Criteria to consider when evaluating EMR/EHR software include:

  • Interoperability with current certification standards (CCHIT [Certification Commission for Health Information Technology], HL7 [Health Level 7])
  • An ACID (Atomicity, Consistency, Isolation, Durability)-compliant relational database for data protection and the ability to recover fully from failure (not just restore from backup)
  • Both thin and fat client support (i.e. remote control and direct control) to accommodate for the lower bandwidth of satellite offices
  • Ease-of-use at the point of care
  • A workflow that matches your practice and specialty

If you purchase a system that matches your requirements, it should provide a speedy ROI regardless of whether or not it is "technically" branded correctly.