An electronic health record (EHR) is an individual's official health document that is shared among multiple facilities and agencies. The role of EHRs is becoming increasing influential as more patient information becomes digital and larger numbers of consumers express a desire to have mobile access to their health records.
Among other types of data, an EHR typically includes:
It is also becoming more common to see medical images attached to EHRs.
The benefits of EHRs include:
The governments of many countries are working to ensure that all citizens have standardized electronic health records and that all records include the same types of information. The major barrier for the adoption of electronic health records is cost.
In order for EHR vendors' products to qualify for use in U.S. government programs such as Medicare and Medicaid, their EHR platforms have to meet certain criteria. The Center for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) created the Medicare and Medicaid EHR Incentive Programs to help make sure EHRs meet certain standards and other criteria. Furthermore, the programs assure healthcare users -- such as hospitals and health systems -- the technology that the EHR system they purchased has the necessary technical capabilities, functions and security in place to meet meaningful use requirements.
Other programs and regulations have also been put in place -- such as meaningful use -- to make sure EHRs meet certain standards and that healthcare organizations are using EHRs in a meaningful way.
In addition, healthcare organizations and EHR vendors must also attest and demonstrate that they have not knowingly and willfully taken action to restrict interoperability of their EHR. CMS and ONC have implemented this attestation requirement in an effort to prevent information blocking.
EHR standards are in place to certify that electronics health records fulfill meaningful use -- in other words, to ensure that EHRs possess necessary technical capabilities and security safeguards.
Another purpose of standards is to help facilitate interoperability. The health IT community has already created the following interoperability standards:
EHRs are able to improve patient care in a number of ways.
For example, they can aid in diagnosis by giving providers access to patients' complete health information, which provides a comprehensive view and helps clinicians diagnose problems sooner.
Furthermore, EHRs can help reduce medical errors, improve patient safety and support better outcomes. While EHRs do contain and transmit data, they also manipulate patient information in meaningful ways and provide that information to the provider at the point of care.
EHRs can also help improve public health outcomes by providing a view of the entire patient population's health information, which lets providers identify specific risk factors and improve outcomes.
EMR stands for electronic medical record. These days, EHR and EMR are used interchangeably and are essentially the same thing. However, government entities such as ONC use the term EHR exclusively.
While many agree that, overall, EHRs offer more benefits than paper health records, EHRs are not without their flaws. Below are some of major differences between paper and electronic records:
There are a series of common and essential features that any EHR system offers. For starters, EHR platforms often set up a patient portal for consumers to access information as well as allow for secure data sharing and data access from other healthcare organizations.
EHRs also typically place patient care orders for clinicians, such as medication orders and diagnostic test requests. In terms of medications, EHRs can manage doses for specific patients and alert physicians to any possible drug interactions. The systems can additionally manage order sets, results and patient consents and authorizations.
Further, electronic health record systems often help coordination clinician workflow management and scheduling. Finally, these systems offer assistance in completing clinical, financial and administrative coding. This feature includes support of service requests and claims for reimbursement.
As of late 2017, the hospital EHR market is largely a battleground between two companies: Epic Systems Corporation and Cerner Corporation. Cerner, a public company, was estimating $5.5 billion in revenue for 2018, while privately held Epic's 2016 revenue has been reported at $2.5 billion by the Milwaukee Journal Sentinel.
Other hospital EHR players include Allscripts and Meditech. Allscripts bought McKesson's hospital EHR products in August 2017, strengthening Allscripts' foothold.
Other vendors that have a stronger presence in the ambulatory healthcare and physician practice EHR market include AthenaHealth and eClinicalWorks.
All EHRs in the U.S. must be Health Insurance Portability and Accountability Act (HIPAA) compliant. This requirement is enforced by the Department of Health and Human Services Office for Civil Rights (OCR).
HIPAA is broken up into two rules: the Privacy Rule and the Security Rule.
The Privacy Rule protects medical records and other personal health information (PHI) via national standards. This applies to covered entities such as health plans, healthcare clearinghouses and healthcare providers that conduct transactions electronically.
The Security Rule protects electronic personal health information (ePHI) that is created, received, used or maintained by a covered entity by establishing national standards.
The Health Information Technology for Economic and Clinical Health Act (HITECH Act) also provides regulations meant to ensure the security of EHRs.
However, HIPAA and the HITECH Act are just the baseline for EHR security. EHRs should also have other security features built into the platform such as an audit trail system, state-of-the-art data centers, access control tools, encryption and more.
Despite the security precautions EHRs can, and often do, take, fear of a data breach is rampant in the healthcare industry. This is not surprising, given that healthcare data breaches where patient records and personal information are compromised happen quite often.
Many experts seem to agree that there is work to be done when it comes to the EHR. Some changes experts hope to see in future EHRs include:
28 Nov 2017