You Ask HIT, We Answer HIT

Delmarva Foundation, Medicare’s Quality Improvement Organization in Maryland and the District of Columbia, answers your questions about health information technology

Question: What’s the difference between an EHR and an EMR and a PHR?

Answer: More alphabet soup! Actually, given our early stage of health information technology, this is not a critical issue of concern. Understanding the differences, however, should help you establish a context in which to consider the various uses and possibilities of HIT for physicians and patients.

A PHR is a Personal Health Record. It contains the medical information of an individual, and it is owned by that individual. A simple example is the list of medications and past medical issues that a patient brings in to your office. When we think about an electronic PHR, we can imagine that same patient having a “smart card” with

X-rays, EKGs and lab results that can be brought to the office, or even to the emergency room.

An EHR is an Electronic Health Record.  This currently refers to a longitudinal electronic record of patient health information produced by encounters in one or more care settings, over a long period of time—ideally, over a lifetime. This would be the manifestation of a community or even a national health information network that would make available to providers health information on a specific patient that is currently sequestered in multiple (usually paper-based) records in the various settings of the health care delivery system. “Ownership” of this information is one of the important issues to be worked out as we develop the ability to exchange health information electronically.

An EMR is an Electronic Medical Record. It is probably the most appropriate term for the software you would acquire for your office to keep your patients’ medical information. A hospital can have an EMR, too. It is the equivalent of the paper chart that you keep on each patient now, and will be subject to the same sort of regulations and record retention policies.

These three records should also come to have a number of things in common. They should be longitudinal, meaning the health information should pertain to a span of years. There should be

immediate electronic access to information, whether for an individual, or for a group (e.g., your practice, your community). They should be secure, accessible by authorized users only. They should be important tools to achieve efficiency and to avoid duplication of services. And most importantly, they should provide information and clinical decision support that will enhance quality and safety in health care.

Questions about HIT? Email them to doqitdelmarva@dfmc.org.

About Delmarva Foundation

Delmarva Foundation is a national, not-for-profit organization dedicated to improving healthcare quality in over 30 states. As the Medicare Quality Improvement Organization (QIO) for Maryland and the District of Columbia, we work with the federal government, state agencies, private organizations, doctors, nurses, consumers, managed care organizations, hospitals, nursing homes, home health agencies, and academic institutions. Our quality improvement efforts include frontline interventions, training, informed choices for consumers, performance review, data analysis, and quality assurance. Our corporate headquarters are located in Easton, Maryland with other offices in Baltimore, Maryland; Washington, DC; Tampa, Florida; and Tallahassee, Florida. We are constantly seeking fresh approaches and new partnerships to accelerate quality improvement. For more information on Delmarva, visit our website at www.delmarvafoundation.org.

Disclaimer:

This article was prepared by Delmarva Foundation, the Medicare Quality Improvement Organization for Maryland, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS policy.

.