EMR/PHR/EHR- We're Good At Confusng People

As part of the American Recovery and Reinvestment Act of 2009 the government included a sizeable chunk-of-change to try to get the health care industry caught up in the world of technology. We all know that with the fragmented system we have today, tests are duplicated, many still rely on paper, and many times the communication and coordination between the patient and the multiple care teams they may access is hindered. Some organizations (Kaiser Permanente, Mayo, Allina Health Systems to name a few) have already made great progress simply due to the delivery structure they use. Most still have a long ways to go.

So, the Department of Health and Human Services produced another monstrosity of a document outlining the “meaningful use” criteria that will be considered to qualify for the billions of dollars eligible for payment if providers (hospitals/physicians/etc.) initiate information technology (IT) in their delivery. These criteria are open for comment with final rules due sometime early in 2010. Doctors and hospitals are already concerned with the “burden” these rules would place on their organizations. Technology companies are encouraged with finally having a roadmap they can follow (See our Blog of April 26, 2009). You can read the document by clicking here.

The goals outlined in the document are admirable; “to improve the quality of health care, such as by promoting the coordination of health care and improving continuity of health care amonth health care providers, by reducing medical errors, by improving population health, by reducing health disparities, by reducing chronic disease, and by advancing research and education.”

But, once again health care is confusing people with its definitions. We’ve also posted a 2006 white paper by HiMSS Analytics providing a pretty decent description of the difference between an Electronic Medical Record and an Electronic/Personal Health Record:
Electronic Medical Record- Clinical data depository, clinical decision support, controlled medical vocabulary, order entry, pharmacy and clinical documentation applications.

Electronic Health Record/Personal Health Record- A subset of the EMR. Owned by the patient- includes patient input and access that spans episodes of care across multiple delivery organizations.

While the DHHS meaningful use criteria reflects an EMR (by the definition above)- they are calling it an EHR. While consumers may have access to the EMR as it is described, they don’t control it. While we certainly need to improve the interface and technology in health care today- the consumer needs to be a part of it- not a victim of it.

Many consumers are already exploring other options to organize and track their health care information. Google Health, Microsoft HealthVault, Mayo, Revolution Health, and others are already providing consumers with software and technology to begin to interact more effectively with the system we have today.

As the delivery system moves forward in improving its communication and coordination by improving its technology- let’s not (once again) leave the consumer to be on the receiving-end of the experience. Let’s also get our definitions straight and make certain we all stay on the same page.

As we know, health care is good at confusing people- even amongst ourselves.